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EVERETT I' <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINQTON <br />PROJECT ADDRESS: 905 94TH ST SE Permil #: B2203-001 <br />TENANT: ITenNamel <br />DESCRIPTION OF WORK: AFH: INTIEXT WORK, LOWER LEVEL ONLY: CONVERT EXTG GARAGE <br />PW Revlewerto select all Mat army babes: <br />Utility PBrlllits (Note: Permit Tecbnenans to Create UtilityPermit for Sewer Water, Fire, and Imga#on, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation 6 Cost Est.) <br />❑ New Connection to main plus connections to building IT New Connection, Size - D Per Cost Estimate <br />❑ Aiteration ❑ Meter Only, Size - D Per Cost Estimate <br />D Repair ❑ Water System Development Fee Total $ <br />❑ Cap -off, quantity D Sewer System Development Fee Total: $ <br />D Reconnection to stub D Water Service Line (behind meter), Size <br />D Backwater Valve D Darkgow Prevenlion (Outside Building): D RPBA or O DCVA <br />C(NOT REQUIRED 'NOT REQUIRED <br />Explanatioml Uglily Permit #: Explanation/ Utility Permit It: <br />IRRIGATION SERVICE:(Nof Including Cost Estimates) FIRE SERVICE:(A#ach Cost Estimate/Rombestiar Reference) <br />❑ New Connection, Size DNew Connection, Size -0 Per Cost Estimate <br />❑ Meter Only, Size ❑ 3W Detect Meter Only, Service See <br />❑ Water System Development Fee Total: $ IT Bxckflow Prevention (Outside Building): D DCDA <br />❑ Backilow Prevention (Outside Building): D DCVA KNOT REQUIRED <br />5kNOT REQUIRED Explanation/ Utility Permit It: <br />Explanation/ Utilily Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED-gf yes, loWRevlewer to send cost estimate request an Wafer Departmeng <br />D Yes, Quantity See attached for reference. <br />NOT REQUIRED <br />PIMTnbing Permits (Note: Permit Technicians to add allifems selected below to PlumbingPermR-forikms inside building orty) <br />O Beckilow Prevention (Inside Building): D DCVA (forponesfic service) O RPBA lye -Di m edlic service) ❑ DCDA (for Fire service) <br />D(NOT REQUIRED <br />Building PCrllllts (Note: Permit Technicians Is add all items selected belowto assocrafed <br />Butlding Panel <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />13 YES, O Sea Attached ((oor calculations / credit <br />To be added on PW'�T'o3- D24 Tobeaddeion {'j1D$,00 <br />❑ YES, Tragk Mitigation Total: $ <br />D See Attached for calculations/credit <br />Quantity charged 14b9 SF Quantity charged l49 9im SF <br />IXHOT REQUIRED <br />is MGqund only O all hard surfaces IIR chiral ❑allhardsuraces <br />$TY STYis <br />❑ NOT REQUIRED <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (now assigned addn:ss), print out Address Letter from TRAKiT Print Menu and include) <br />DYES -TYPE: DSFR ❑DUPLEX ❑ADD ❑INFILLDWELLING ❑MULTI -FAMILY OCOMMERCIAL <br />❑ See AOachad Letter, 2 copies (Permit Techs to issue one copy b applicant wiM permlh, scan one copy m Jeffrey Meds) <br />❑ Digital copy attached to permit record, Permit# <br />❑ Saved to Morass Folder in Development Tech File <br />{$ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />D YES -Type <br />ID NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />MYES,Pemlll#PW 1P 1 <br />R[Stomwater NPOES Tab Completed in TRAKT SlADATab Compleledin TRAKiT kspections Added In TRAKIT <br />❑ NOT REQUIRED <br />hPyYYWku 0yi�2,�IQ01i- <br />Worksheet Completed By: Data: <br />Me"I eat Checked By: Date: 2E IDh <br />