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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2020 LAKE HEIGHTS DR Permit#: B2504-048 <br /> DESCRIPTION OF WORK: WA6981 SILVER LAKE RELO Cell Site RF Modifications <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 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 ❑ DCVA <br /> ® NOT REQUIRED ® NOT 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 ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building): ❑ DCDA <br /> ❑ Backflow Prevention(Outside Building):❑ DCVA ® NOT REQUIRED <br /> ® NOT 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,Quantity ,See attached for reference. <br /> ® NOT REQUIRED <br /> Plumbing Permits(Note:Plumbing Contractor to apply for all items inside building selected below) <br /> Backflow Prevention(Inside Building): ❑ DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT 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 ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ® NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces QTY is❑ Roof only❑all surfaces <br /> ® NOT REQUIRED <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# <br /> ❑Saved to Address Folder in Development Tech File <br /> ® NOT REQUIRED <br /> FIRE 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: ane Date:05/1 f/L`OL`5 <br /> Worksheet Reviewed By:14064M SGlZe'Z m Date:0511412025 <br />