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477 PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 1308 BALLEW AVE Permit#: C1808-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADD(4)ROOMS&COVERED DECK <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: (Not Including Cost Estimates) <br /> ❑ New Connection 0 New Connection, Size <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off 1E-NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> IE-NOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Not Including Cost Estimates) <br /> ❑ New Connection, Size 0 New Connection, Size <br /> ❑ Meter Only, Size 0 3/4'Detect Meter Only, Service Size <br /> ❑ Backflow Prevention(Outside Building): 0 DCVA 0 Backflow Prevention(Outside Building): 0 DCDA <br /> IrNOT REQUIRED la NOT REQUIRED <br /> Explanation/Utility Permit#: 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 /> KNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> ❑Water Service Line(behind meter), Size <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> IRLNNOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑YES,Water: $ 0 YES, $ <br /> Sewer:$ 0 See Attached Spreadsheet for calculations/credit <br /> ❑ See Attached Spreadsheet for calculations/credit ®-NOT REQUIRED <br /> IE-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 <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# <br /> p-NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> IE-NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> BYES, Permit#PW tom$•oco� <br /> Ig.Stormwater NPDES Tab Completed in TRAKiT JB.QDA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Aor <br /> Worksheet Completed By: Date: g/2.$0 <br /> AfAir <br /> Worksheet Checked By: >;�.._:, ► ,, Date: f <br /> C/a,' <br /> 411, <br /> REVISED 8/6/2018 <br />