8910 4TH PL SE 2019-11-14 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# \7)VI LCj'O6 \ { BUILDING PLANNING Intake OK by: ' Date: c 5/l //9 Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. Route 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/ esso truct.Size S/ Zone L_I-. Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction . Residential Use At64.61Q.3 `j'PR Occupancy Group Proposed No. of Dwelling Units: -------- Occupancy Load Total No. of Dwelling Units: 4.._ Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before F' al? ❑Yes'No Reason Sprinklers Required: . "In Lieu"Fee:Type: mount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ .,..-"Reason Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ErNo ❑Everett School Dis ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 1No Additional Notes: VALUATION CALCULATION: Total$ Z-1-0 Approved By: 4,11,,...„) Date: 5-I-151 PUBLIC WORKS Intake OK by: _ G�J' Date: �l/�20(9 Additional Notes: Z ,'5 /46._ Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: • i'tk-' Date: 5-17//ci ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet Separate I 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 ❑ 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 O Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder Goin with this folder for permit issuance) O 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: A],6 L^ S �� / � [a -1 dienk- ELECTRICAL T�1 ih SSE �, �, Additional Notes: Approved By: Date: Approved By: Date:5-/12J/7