1410 HOLLOW DALE PL 2019-09-23 - Laserfiche WebLink

Intake &Approval Sheet ,w pp (FOR PERMIT STAFF ONLY I PERMIT# tJ I bf��'�°0 BUILDING PLANNING Intake OK by Date:OS//'Y/l a Intake OK b1 '(_.------ `4, Date: 4i i4 /1k Intake Comments: Intake Comments: Assign To: 4/-e/(/61 ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ,❑., RRoo to to Historic Reviewer ❑ Make this a"W" Permit LST OK to Route to Other Departments 00014 i Bldg/TI(Addn em Size 1 736 0 Planning File Drawer . ictuktw a“ I Garage/Accessory Struct. Size g...33 a cve+-4.) p%" Zone V—2-- Number ZNumber of Stories g. Overlay/Agreement Basement t4No El Yes , Fin/Unfin Nonresidential Use Type of Construction V`3 Residential Use `Ciire Occupancy Group 3 Proposed No. of Dwelling Units: I Occupancy Load --Ar Total No.of Dwelling Units: '2. Fire Sprinklers: ❑Update Existing ❑New System YJ Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes L`9No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System E1Not Req'd School Impact Fee: Total $ 1 i 1,-1-53'te Reason Fire Alarm Required: Calculated: Credit: 1/2 O ( 4 iU 'E2e Cecil4- RCW 64.55 MF worksheet req'd for permit? ❑Yes rg No r !Everett School Dist ErMukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes t3No Additional Notes: VALUATION CALCULATION: Total$ j,'1 S 2.,,+CI Approved �► Date: i. lZ -Ii k PUBLIC WORKS) Intake OK by: Date: g/ H'yi Additional Notes: 20 /4-- //2..C.... Er buses Intake Comments: PW Worksheet Needed if: AS '( r 4 ' 6 S Sys Dev Eval Traffic IVGt v-I IvQ .{�, 1 ' n❑Site Work or Drainage Proposed Approved By:e....„&"'"2-;--- Date: I C no/ i Seg._r� 1t i • , "��""' 'Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, 2 E fl . 9 AQt supportive housing) FIRE:DEPARTMENT Route this folder fort PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND El Create Green Folder El Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team This Permit is Approved by Public Works Date: (OK to Route to Other Departments) See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ❑New System Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ❑New System Jot Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existing ❑New System Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:,. 11�,�,a,4, Date: i..),Date: -(Pj 0 Public Works has no scope--- PW Not Required I i Additional Notes: / ELECTRICAL Additional Notes: Approved By: Date: Approved By*�' ✓�. �ate: /1/.?—$/?E>6!1