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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1724 100TH ST SW Permit#: B2207-083 <br /> TENANT: <br /> DESCRIPTION OF WORK: NEW SFR& DRIVEWAY-LOT B, EAST HOUSE <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 It New Connection, Size 3 14 -❑ Per Cost Estimate <br /> ❑Alteration ❑ Meter Only, Size -❑ Per Cost Estimate <br /> ❑ Repair IN Water System Development Fee Total: $ LN I.0D <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total: $ rl 1A <br /> ❑ Reconnection to stub ❑Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or❑ DCVA <br /> RI NOT REQUIRED pp ❑ NOT REQUIRED 0 L`) <br /> Explanation/Utility Permit#AWA\\ 60 Explanation/Utility Permit M V <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 /> ❑ Backflow Prevention (Outside Building): ❑ DCVA M NOT REQUIRED <br /> 0 NOT REQUIRED Explanation/Utility Permit M <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewerto send cost estimate request to Water Department) <br /> ❑Yes, Quantity See attached for reference. <br /> I$ 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 /> WNOT REQUIRED <br /> BuildinC,j Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: Go <br /> 0 YES, M See Attached for calculations/credit M YES,Traffic Mitigation Total: $ Ll'lq3. <br /> o e —ea, n To be added on ❑ See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is❑ Ground only rA all hard surfaces QTY is ❑ Roof only❑ all hard surfaces <br /> ❑ NOT REQUIRED al <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br /> M YES—TYPE: IA SFR ❑ DUPLEX ❑ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL <br /> 6 See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> Q Digital copy attached to permit record, Permit# tllb-l-o IIJ <br /> LA Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> 9 NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ff—YES, Permit#PW /L14 - b">4 <br /> I'Stormwater NPDES Tab Completed in TRAKiT DADA Tab Completed in TRAKiT Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Dateb <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />