10330 4TH AVE W 2020-05-21 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT a'1,4 0 \'---O 4 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 4-1-() 0 Hold in Planning File Drawer Garage/Accessory Struct. Size -- Zone 0 1 Number of Stories ± Overlay/Agreement Basement ruNo DYes , Fin/Unfin Nonresidential Use . II Type of Construction V' Q- Residential Use f if�'CA f ji\fI ^1 Occupancy Group 4 Proposed No. of Dwelling Units: % ,t,dk _ik Occupancy Loa 4— Total No. of Dwelling Units: Fire Sprinklers:�Update Existing Chew 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 No ❑Everett School Dist DMukilteo School Dist L_ Add'I RCW 64.55 docs required prior to final? ❑Yes o Additional Notes: „G ba(At- .ra ' VALUATION CALCULATION: Total$ s K6141164. ' Approved By: Date: ` iltlici PUBLIC WORKS Intake OK by: R/ Date: 7(( / Additional Notes: Intake Comments: PW Worksheet Needed if ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: ` II 1C3r ❑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 Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) El Route to Fire Drawer---FirePreiiminary Review Notice AND El Create Green Folder ❑Submitted Previously ODeferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: DUpdate Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND ❑ Is located in this folder Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: jg Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: 41 Approved By: Date: Approved By:1OP ;ii Date: / pt'I/ ^- Or (2:4)