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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2313 COLUMBIA AVE Permit#: PW2211-006 <br /> TENANT: <br /> DESCRIPTION OF WORK: BUILD NEW DADU <br /> PW Reviewer to select all that a 1 below: <br /> Utility Permits (Note:Permit Technicians to Cre ity PeIlanation/ <br /> Sewer, Water, Fire, and Irrigation, as selected below) <br /> SANITARY SEWER: MESTIC WATER SERVICE: (Attach Calculation& Cost Est. <br /> ❑ New Connection to main plus connections to buildingNew Connection, Size -❑ Per Cost Estimate <br /> j�Alteration Meter Only, Size - ❑ Per Cost Estimate <br /> ❑ Repair Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity Sewer System Development Fee Total:$ <br /> ❑ Reconnection to stub Water Service Line(behind meter), Size <br /> ❑ Backwater Valve Backflow Prevention (Outside Building): ❑ RPBA or❑ D A <br /> ❑ NOT REQUIRED NOT REQUIRED c <br /> Explanation/Utility Permit#: U2,sk Z—03� Utility Permit#: u %\2-03 S <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 ❑%" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): ❑ DCDA <br /> ❑ Backflo revention (Outside Building): ❑ DCVA 19 NOT REQUIRED <br /> NOT QUIRED Explanation/Utility Permit#: <br /> Expl ation/Utility Permit#: <br /> WATER DEP RTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewerto send cost estimate request to Water Department) <br /> ❑Yes, Qu tity See attached for reference. <br /> d NOT KQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ BackVQ' <br /> Prevention (Inside Building): ❑ DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> t NOTUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected belo o associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT EES: TRAFFIC MITIGATION FEES: <br /> YES,t See Attached for calculations/ edit ❑YES,Tr ffic Mitigation Total: $ <br /> To be added on PW 22 -DI�(o To be added on a��-0 'B ❑ S Attached for calculations/credit <br /> Quantity charged (O70 S Quantity charged DD SF Q4.N0 REQUIRED <br /> QTY is IXGround o 1 ❑all hard surf ces QTY is 1A Roof only❑all hard surfaces <br /> $ '101. $ D,3 <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes ( assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> D YES—TYPE: ❑SFR ❑ DUPLEX rA ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL <br /> 9 See Attached Letter,2 copies (Permit Techs to issue one co y to ap licant with permits, scan one copy to Jeffrey Marks) <br /> Ii4 <br /> Digital copy attached to permit record, Permit# 1a22O -(7D� <br /> 1�Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> 0 NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW 11-1 1--00(o <br /> ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: �0 <br /> Worksheet Checked By: Date: 1 1 °-7 l Zo Z Z <br /> REVISED 1112712019 <br />