5008 NICHOLS PL 2019-11-06 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# ;1 © -6/1 BUILDING PLANNING Intake OK by: Date: 5/(1/ I q Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ARoute to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size _ 0 Hold in Planning File Drawer / Garage/ cessory truc ize ‘78 5(` Zone Number of odes Overlay/Agreement Z Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction 7.1? Residential Use ZZ Occupancy Group (A, Proposed No. of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Rei ired before Final? ❑Yes ❑No Reason Sprinklers Required: . "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total l: Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes aNo ❑Everett School P st ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 3No Additional No -s: VALUATION CALCULATION: Total$ (6.q.so Approved By:l0t�-� Date: 5/ Imo/ ) I PUBLIC WORKSItake OK by: j“.. Date: g//Si Zlll°j ( / �R Additional Notes: Z a f /2 C Intake Comments: ��, PW Worksheet Needed if: mgt._ C._ 6 v " f,I ( ��_ _ ❑Sys Dev Eval ❑Traffic Mit Eval I vv ��7�c,��. ❑Site Work or Drainage Proposed Approved By: <541Date: 6//2 fey � 1 VGtiJ` ❑Backflow Prevention for high hazard: (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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑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 Qoin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By:/.Af ,74-- Date:45/21,