5102 DELAWARE AVE 2019-11-01 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# I I g t 0 J -O\ BUILDING PLANNING Intake OK by: 1- Date / L//7 Intake OK by: Date: Intake Comments: Intake Commen : Assign To: 6kKz %V No Gi c- ❑ Route.to Commercial Building 0 Attach to Project No. ;t Route to Residential Building 0 Route to Historic Reviewer PirMake this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addr to Size 3GO S1 0 Hold in Planning File Drawer Garage/Accessory Struct.Size l. 14 Zone ''''>:i"! V -\ Number of Stories ( Overlay/Agreement Basement ❑No , Yes ,n/Unfin Nonresidential Use Type of Construction 1 Residential Use r k.) —. Occupancy Group Q L Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes itillNo Reason Sprinklers Required: "In Lieu"Fee:Type: ount$ Fire Alarm: El Update Existing El New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes KNo ❑Everett School ist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes faiNo Additional N s: VALUATION CALCULATION: Total$ 25156,0 / 44o 2 't- 41,kw ie-2 3&D sf- a Approved By: fr.—) Date: "-S1_2_20\91 PUBLIC WORKS Intake OK by` Th Date: 3/2242 0 19 Additional Notes: 20/S 02L g (V.SSG Intake Comments: PW Worksheet Needed if: I,r t-r -'oma —e9EN— ❑Sys Dev Eval ❑Traffic Mit Eval 4.10 0t:Scpc jvi- EISite Work or Drainage Proposed Approved By: 474 Date:3/ �! ❑Backflow Prevention for high hazard: l" (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ►%= -relic Works has no scope---PW Not Required Additional Notes: 7-ELECTRICAL ' - - "' l 3 122/*Lo 19 Additional Notes: Approved By: Date: Approved By: Date: :`"�\