Laserfiche WebLink
• <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Z I goS - Z <br /> BUILDING / PLANNING <br /> Intake OK by: .ICI - Date:/ 2 `/8 Intake OK by: Date: 4-Zt-)' <br /> Intake Comments: Intake Comments: Assign To: u-`1nc) <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 P.OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/ ccesso truct. Size '2_53' s-r-, Zone iz-'1 <br /> Number of Stories t Overlay/Agreement <br /> Basement P,No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Y- Residential Use hstko a- til <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System Kot Req'd Planning/Landscape Inspection Required before Final? ❑YesNo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing ONew System RNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes at r No El Everett School Dist ❑Mukilteo School Dist <br /> r <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes L1 No Additional Notes: bloets 04 cs e- do 0A-- r.-eek CA <br /> VALUATION CALCULATION: Total$ 6g25- (.00,410.- 5a <br /> 6, -redAn- iy loci owl— floqu• 'we — <br /> cAtnnIa, <br /> Approved By: „` )A. Date: lo-10-ice <br /> PUBLIC WORKS <br /> Intake OK by:T +J Date: a/2bii 4> <br /> Additional Notes: 16— pe-C Intake Comments: PW Worksheet Needed if: <br /> tilF w •DG«4 124 5¢ ❑Sys Dev Eval ❑Traffic Mit Eval <br /> PA PC?s ❑Site Work or Drainage Proposed <br /> Approved By: " Date:/0/z/jam ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT Route 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 /> ❑Sending Fire Notes to Project Team ❑This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑j <br /> New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: 1/114 tj ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:y Date: IA Public Works has no scope---PW Not Required <br /> Additi nal Notes: <br /> ELECTRICAL CA.12-e4L 4.72a6,.%.‘ <br /> Additional Notes: . (_._ tiJ' 4z, 0 <br /> Approved By: Date: Approved By: Date: 1/40/1/'1.,J --.. <br />