124 69TH PL SE 2020-02-25 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# --1° 09+ Oa l BUILDING PLANNING Intake OK by: Date: 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/Accessory Struct.Size Zone S2.--2 -- Number of Stories Overlay/Agreement Basement 0 N ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use 1 Occupancy Group Proposed No. of Dwelling Units: -- Occupancy Load Total No.of Dwelling Units: Z _ Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo Reason Sprinklers Required: . "In Lieu"Fee:Type: Amount /' Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: redit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: Qn.na( Ci Q.165' - no CIA0f QyC1} VALUATION CALCULATION: Total$ SoloL. le'5 4-0 -e.$1L U Approved By: / Date: -Zp...Iq PUBLIC WORKS Intake OK by: Date: Additional Notes:TSL "V-r''"-'t- Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: r Date: qpt,/1/ ❑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/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: 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 0 Is in a Separate Green Folder(loin 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 d itional Notes: ELECTRICAL Additional Notes: \l/b. ' AI(V‘f,d Approved By: Date: Approved By: Date: