Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# l._._(.z0 1 ,00--( <br /> BUILDING PLANNING <br /> Intake OK by: 6+ Date: Intake OK by:� ...c?'....? Date: CA` A. ` 2CA - <br /> Intake Comments: Intake Comments: Assign To: 04\ Q <br /> %\e_Q1o,,A Csa.l\I\e-eVxYAs <br /> c0\veAl € C <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W" Permit fI OK to Route to Other Departments <br /> 9TI/Addn/Rem Size .3 i57 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size 6/7 7 36.7 Zone c2 - S <br /> Number of Stories 2- Overlay/Agreement <br /> Basement ANo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction .T4/ Residential Use sf-K <br /> Occupancy Group IL Proposed No.of Dwelling Units: 1 <br /> Occupancy Load Total No. of Dwelling Units: C!)./1'2- <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes o <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ LA,'L \. `I° <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes xi No DEverett School Dist ®Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes giNo Additional Notes: <br /> VALUATION CALCULATION: Total$ 1067464 \-\e,\t\ vkty Ql vv\ ce_r,se& S 'k 1- <br /> , <br /> Approved By: Date: \ . 12 2ea <br /> PUBLIC WORKS <br /> Intake OK by: Date: V / t <br /> Additional Notes: 2 o/s- 1 jc i j4.9.57gL Intake Comments: PW Worksheet Needed if: <br /> P, \ ❑Sys Dev Eval ❑Traffic Mit Eval <br /> 11�J ❑Site Work or Drainage Proposed <br /> Approved By: d r Date: ijh 1 i ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENTRoute this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary Review Notice AND,Create Green Folder ❑Submitted Previously ❑Deferred <br /> El Sending Fire Notes to Project Team b4 This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) Q' See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System .'•Not Req'd 4� A Separate PW Permit is Required (Permit#: PW 9804-(5 r'7 ) <br /> Fire Alarm: ❑Update Existing ❑New System 1t Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System K) Not Req'd Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By. '�n Date: i2//g//4" 0 Public Works has no scope PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved : . % �% Date: i . , , �� 15 __ <br />