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E VE R E T T PUBLIC WORKS REVIEW WOR <br /> WASHINGTON KSHEET <br /> PROJECT ADDRESS: 3702 HOYT AVE UNIT B Permit#: B2309-027 <br /> DESCRIPTION OF WORK: CONVERT BASEMENT OF UNIT B INTO ADU AND ADD BATHROOM <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 ,Size Onl <br /> ❑ Repair Y -El Per Cost Estimate <br /> ❑ 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 alve ❑ Backfl Prevention(Outside Building):❑ RPBA ❑DCVA <br /> ® NOT UIRED ® REQUIRED <br /> Explanation/Utility Permit# 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 ❑ W'Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backf Prevention(Outside Building):❑DCDA <br /> ❑ Backfl Prevention(Outside Building):❑ DCVA ® REQUIRED <br /> ® NO Prevention <br /> Explanation/Utility Permit# <br /> planation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Q tity_See attached for reference. <br /> ® NO EQUIRED <br /> Plumbing Per .s(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow P ention(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> ® NO EQUIRED <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 ❑ YES,Traffic Mitigation Total:$ <br /> To be added on PW To be adde ❑See shed for calculations/credit <br /> Quantity charged SF Qua5 Wi charged SF ® NO QUIRED <br /> CITY is❑Ground only❑all surfaces is❑Roof only❑all surfaces <br /> ® NOT REQUIRED <br /> dditional 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 Jeffrey Marks) <br /> ® Digital copy attached to permit record,Permit#62309-027®Saved to Address Folder in Development Tech File l.JvL/ <br /> NOT REQUIRED <br /> F E SPRINKLERS REQUIRED? <br /> YES Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT [—] Inspections Added in TRAKiT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: !p/md 7&a0mt Date:09113/2093 <br /> Worksheet Reviewed By: Date: 0 <br /> 7-!3 - 70 Z3 <br />