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EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 9532 7TH AVE SE Permit#: B2403-077 <br /> DESCRIPTION OF WORK: NEW SINGLE FAMILY HOME-RB2306-001 THELON-CHELSEA HEIGHTS 10 <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, ter,Fire,and Irrigation,as selected below) <br />(SANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est.) <br /> ® New Connection to main plus 1 connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 1 inch-❑ Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,577.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$4,028.00 <br /> ❑ Reconnection to stub ® Water Service Line(behind meter),Size 1 inch <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED ( - c ❑ NOT REQUIRED <br /> \ Explanation/Utility Permit A2_w o Js Explanation/Utility Permit# <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Det ct Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Ba ow Prevention(Outside Building):❑DCDA <br /> ❑ Backfl Prevention(Outside Building):❑DCVA OT REQUIRED <br /> ® NO EQUIRED Explanation/Utility Permit# <br /> planation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Q Antity ,See attached for reference. <br /> ® NO EQUIRED <br /> Plumbing Permits(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow Pr ntion(Inside Building): ❑ DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> ® NOT QUIRED <br /> Buil ng Permits(Note:Permit Technicians to add I items selected below to:clatea <br /> Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ® YES,®See Attached for calculations/cr dit ® YES,Traffic Mitigation Total:$5,592.00 <br /> To be added on PW To be added on B2403-077 ®See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 1504SF ❑ NOT REQUIRED <br /> QTY is❑Ground only El all surfaces QTY is® Roof only El all ces <br /> $ 449.40 <br /> ❑ NOT REQUIRED -01 <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 ❑MULTI-FAMILY ❑COMMERCIAL <br /> ®See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits,scan one copy to PWClerical@everettwo.gov) <br /> ®Digital copy attached to permit record,Permit#— 2_%/p3— O- <br /> Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES—Type 13D <br /> ❑ NOT REQUIRED <br /> Reason:Per note on civil plan <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2403-033 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT Prispections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Zme Date:031R912024 <br /> Worksheet Reviewed By:,10� Date: (D-3- <br />