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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 9516 7TH AVE SE Permit#: B2403-080 <br /> DESCRIPTION OF WORK: NEW SINGLE FAMILY HOME-RB2306-001 THELON-CHELSEA HEIGHTS 45 <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 /> E New Connection to main plus 1 connections to buildirV ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,size 1 inch-❑Per Cost Estimate �V- <br /> ❑ Repair E Water System Development Fee Total:$4,577.00v/�j <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$4,028.00✓ ���a' <br /> ❑ Reconnection to stub E Water Service Line(behind meter),Size 1 inch✓ <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED (� ❑ NOT REQUIRED '' AA Il f <br /> Explanation/Utility Permit# �l U✓I�J Explanation/Utility Permit# V`� <br /> IRRIGATIONS ICE:(Not Including Cost Estimates) FI S ICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ N w C nection,Size ❑ ew Connection,Size -❑Per Cost Estimate <br /> ❑ M r Only,Size 3,'Detect Meter Only,Service Size <br /> ❑ ate System Development Fee Total:$ Ba flow Prevention(Outside Building):❑ DCDA <br /> ❑ Backflow Prevention(Outside Building):❑DCVA E NOT REQUIRED <br /> ® NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> ATE bEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> es,Quantity ,See attached for reference. <br /> NOT REQUIRED <br /> Plumbing Permits(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> B ow Prevention(Inside Building): ❑DCVA(for Domestic service) ❑RP BA(for Domestic service) ❑DCDA(for Fire service) <br /> T REQUIRED <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 /> E YES,E See Attached for calculations/credit ®YES,Traffic Mitigation Total:$5,592.00 <br /> To be added on PW To be added on B2403-080 ®See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 1504SF ❑ NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces CITY is E Roof only❑all surfaces <br /> $ $449.40 <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 /> E YES—TYPE:E SFR ❑DUPLEX ❑ADU ❑INFILL DWELLING ❑MULTI-FAMILY ❑COMMERCIAL <br /> E See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits,scan one copy to PWClerical@everettwo.gov) <br /> E Digital copy attached to permit record,Permit#B2403-080 <br /> E Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> E YES—Type 13D <br /> ❑ NOT REQUIRED <br /> Reason:Per note on civil plan <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> E YES,Permit#PW2404-046 <br /> E Stormwater NPDES Tab Completed in TRAKiT E ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: "0a Date:04116/2024 <br /> Worksheet Reviewed By:T� Date:- 0�1*4/ 7,024 <br />