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EVE R E TT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 3904 FEDERAL AVE Permit#: BW2106-002 <br /> DESCRIPTION OF WORK: PARTIAL BASEMENT REMODEL REV AFT ISSUE ADDING ADU IN BASEMEN <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water,Fire,and Irrigation,as selected below) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est.) <br /> ❑ New Connection to main plus connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ❑ Meter Only,Size -❑ Per Cost Estimate <br /> El Repair ❑ Water System Development Fee Total:$ <br /> El Cap-off,quantity El Sewer System Development Fee Total:$ <br /> ❑ Reconnec on to stub ❑ Wat r Service Line(behind meter),Size <br /> ❑ Backwa r Valve 0 B flow Prevention(Outside Building):❑RPBA ❑ DCVA <br /> ® NOT QUIRED ® OT REQUIRED <br /> Explanation/Utility Permit# Explanation/Utility Permit# <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> El New Connection,Size El New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size El %"Detec Meter Only,Service Size <br /> ❑ Water Sy em Development Fee Total:$ ❑ Backfl Prevention(Outside Building):El DCDA <br /> El Backflo Prevention(Outside Building):❑DCVA ® NO EQUIRED <br /> ® NOT QUIRED Explanation/Utility Permit# <br /> Expl nation/Utility Permit# <br /> WATER DEPA TMENT COST ESTIMATE NEEDED-(/f yes,PW Reviewer to send cost estimate request to Water Department) <br /> El Yes,Qu tity ,See attached for reference. <br /> ® NOT QUIRED <br /> Plumbing Per its(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow Pre ention(Inside Building): ElDCVA(for Domestic service) ❑RPBA(for Domestic service) ElDCDA(for Fire service) <br /> ® NOT R UIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit 0 YES,Tr c Mitigation Total:$ <br /> To be added on PW To be added on ee Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ® REQUIRED <br /> QTY is El Ground only❑all surfaces QTY is El Roof only El all surfaces <br /> $ $ <br /> ® NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) <br /> ® YES—TYPE:❑SFR ❑DUPLEX ®ADU ❑INFILL DWELLING El MULTI-FAMILY El COMMERCIAL <br /> ®See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits,scan one copy to Jeffrey Marks) <br /> ®Digital copy attached to permit record,Permit#BW2106-002 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> El YES Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> El YES,Permit#PW <br /> El Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT El Inspections Added in TRAKiT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: 74ad%1,e0frepte Date:1011312023 <br /> Worksheet Reviewed By:kvir, JftM'14\aQate: D (� <br />