1802 75TH ST SW 2020-02-25 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#VI D' '022- BUILDING PLANNING Intake OK by: Date: " i yloi Intake OK by:__ Date: CV/7 /I CI Intake Commen : Intake Comments: Assign To: i \lercq w(storl2 wd-ii ,-t.. ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building Route to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group 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 ❑No 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: Credit:_ RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: i�r V A„ �„t fit `s itz ccu - tV";,2.d VALUATION CALCULATION: Total$ CD2) 000 -C S,I t_01 � vl Approved By;/ Date:9 l�/I q ` 11 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: ic� Date: 4=1 I tvI 149 ❑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: ❑ This Permit is Approved by Public Works OUi}ot o - ‘6-40\ CV A�1 11 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 ��0 Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) li�l-Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:& 61 N,A Date: 10 '\ —i ot Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL MO I•+�Ew ty,` 'a..,E,s LA.C.D w►'A>-D -suds-�aCL� ,A4t,C,A- Additional Notes: ?/3o /19 Approved By: Date: Approved By: D 2 _.7