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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2825 HOYT AVE Permit#: B2404-028 <br /> DESCRIPTION OF WORK: NEW PRE-FAB CMU SIDEWALK RESTROOM <br /> PW Reviewer to select all that apply below: <br /> tility Permits (Note:Permit Technicians to Create Utilit mit for Sewer, W 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 -❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$7,644.00 <br /> Cap-off,quantity ® Sewer System Development Fee Total:$6,727.00 <br /> Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ® Backflow Prevention(Outside Building):® RPBA ❑DCV <br /> ❑ NOT REQUIRED tp�` ❑ NOT REQUIRED <br /> Explanation/Utility Perm it# 2�5 -02.'+ Explanation/Utility Permit# 2�5 -O2 <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) E SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> ❑ Water ystem Development Fee Total:$ ckflow Prevention(Outside Building):❑DCDA <br /> ❑ Bac ow Prevention(Outside Building):❑ DCVA NOT REQUIRED <br /> ® T 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, antity.,See attached for reference. <br /> ® NO REQUIRED <br /> Plumbing Pe mits(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow revention(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑ D CDA(for Fire service) <br /> ® N 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 /> ❑ YES,❑See Attached for calculations/credit ❑ YES,Traffic Mitigation Total:$ <br /> To be added on PW To be added on ❑Se ached for calculations/credit <br /> Quantity charged SF Quantity charged SF ® NO QUIRE <br /> QTY is❑Ground only❑all surfaces QTY is❑Roof only❑all surfaces <br /> ® NOT�RU D <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#B2404-028 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES— pe <br /> ® NO REQUIRED <br /> R ason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2404-064 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ®Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: 74/4d Date:04/211/2024 <br /> Worksheet Reviewed By:Tt /Q��l Date:04/2c1/2024 <br />