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E V E R E T T <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 9536 7TH AVE SE Permit #: B2403-082 <br />DESCRIPTION OF WORK: NEW SINGLE FAMILY HOME-RB2306-001 THELON-CHELSEA HEIGHTS 41 <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 1 connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />Alteration 49 Meter Only, Size 1 inch - ❑ Per Cost Estimate <br />❑ Repair Water System Development Fee Total: $4,028.00 <br />❑ Cap -off, quantity Sewer System Development Fee Total: $4,577.00 <br />❑ Reconnection to stub %JM Water Service Line (behind meter), Size 1 inch <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA ❑ DCVA <br />❑ NOT REQUIRED �� nn ❑ NOT REQUIRED I <br />Explanation/Utility Permit # !�"I V"I J U rl Explanation/Utility Permit # YM " c 1� <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Requestfor Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ %" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA <br />❑ Backflow Prevention (Outside Building): ❑ DCVA ® NOT REQUIRED <br />® NOT REQUIRED Explanation/Utility Permit # <br />Explanation/Utility Permit # <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, 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 />Backflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />® NOT REQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />® YES, ® See Attached for calculations / credit / <br />® YES, Traffic Mitigation Total: $5,592.00 <br />To be added on PW To be added on B2403-082 `// <br />® See Attached for calculations/credit <br />Quantity charged SF Quantity charged 1504SF <br />❑ NOT REQUIRED <br />QTY is ❑ Ground only ❑ all surfaces QTY is ® Roof only ❑ all surfaces <br />$ $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 />® 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@everettwa.gov) <br />® Digital copy attached to permit record, Permit #B2403-082 <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 # PWPW2404-036 <br />® Stormwater NPDES Tab Completed in TRAKiT ® ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By: 7noa a Date: 0410912024 <br />Worksheet Reviewed By:Ad4 Date: _tnfj � JZ -20 2,4 <br />