9010 4TH AVE W 2020-06-15 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 6 I IZ t e1 BUILDING PLANNING Intake OK by: 4"/"- Date: /244/0 Intake OK by: 0- Date: 12 - 4S Intake Comments: Intake Comments: Assign To: h-, .,y.', i -,112,r \ - >\c .5 ❑ Route to Commercial Building 0 Attach to Project No. la Route to Residential Building 0 Route to Historic Reviewer O Make this a"W" Permit r4 OK to Route to Other Departments Y-4.-- z"-2-1-19 Bldg/TI/Addn/Rem Size 'WO Z 411 old in Planning File Drawer )64-- Garage/Accessory Struct.Size 61/6 Zone R'. Number of Stories Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use --- Type of Construction Residential Use jPV.--- Occupancy Group f a Proposed No. of Dwelling Units: 6.., Occupancy Load Total No. of Dwelling Units: I..._ Fire Sprinklers: ❑Update Existing [hew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ENo Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ L12_1S Reason Fire Alarm Required: Calculated: 117-15--- Credit: X.i- RCW 64.55 MF worksheet req'd for permit? ❑Yes Re No ❑Everett School Dist 94mukilteo School Distp Add'I RCW 64.55 docs required prior to final? ❑AYes EtNo Additional Notes: Let V' (,ic u` d c Q VALUATION CALCULATION: Total$ ' b2 Gid? ,(Lg J(r.I t `"'IIJJ��'' *- i \ acze,55OM � d.u(A�+ z 7 e- I1 , ,.n, 32_ ZC U �J 52.% 16 2 Lt y 2 enApproved By: C, Date: ?- ,7)--I ZO 3 G' 30 ( 0.5 O PUBLIC WORKS Intake OK by: I l'A Date: 121 1 R 1261 e Additional Notes: ZOlc l/26_ Uv Intake Comments: PW Worksheet Needed if:: N..E••÷4 Sc ig. Sys Dev Eval Pfraffic Mit Eval grSite Work or Drainage Proposed 12 rU S r' cz_E.�L,ac�'0 Approved By: ‘ M - Date:3/1h Yq.),,,aL-, ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT i2 -oute 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) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0-4 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) FA- ee PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ❑New System in Not Req'd PIA Separate PW Permit is Required (Permit#: PW 19c)3-of 9 ) Fire Alarm: ❑Update Existing [hew System in Not Req'd AND Kis located in this folder Chemical Sup: ❑Update Existing ❑New System in 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)rip, Approved By: y Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved B . Date: 3 ig/24 ii