9105 10TH PL W 2020-08-28 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#C 9 —0o9 BUILDING PLANNING Intake OK by: Date: `"/Izs/re, Intake OK by: Date: 61/Z046 Intake Comments: Intake Comments: Assign To: I� o Route to Commercial Building 0 Attach to Project No. gi Route to Residential Building 0 oute to Historic Reviewer ❑ Make this a"W" Permit OK to Route to Other Departments :Idgf I/Addn/Rem Size q'23 5.K 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone ?N"'1 Number of Stories Overlay/Agreement Basement i.No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction 1`V Residential Use (912.60 , S'-P Occupancy Group 1 Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System INot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ,1� 10 Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ / Fire Alarm: ❑Update Existing ❑ I�1New System J Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr ' . RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 N ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El-No Additional Notes: ,, Dh 'o 'b ol►LK — n0 J VALUATION CALCULATION: Total [IL( L(� (a r; /0, cii1.+ , r,,,4-- J Approved By: f l Date: rz.- K— ((l PUBLIC WORKS Intake OK by:AEDate: 9Og/2eig Additional Notes: Zo/s /AC ir 4f S L Intake Comments: PW Worksheet Needed if:AJO7 fE a ❑Sys Dev Eval ❑Traffic Mit Eval dt,_1i r ,.L,o A/410 ❑Site Work or Drainage Proposed vd Approved By: ," Date: 1 f`z1 IA Y �� J ,?i0 ElBackflow Prevention for high hazard: (� (dental,medical,animals,mortuary,hospital, 6)96-4� • supportive housing) FIRE,DEPARTMENT ZRoute 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 TeamThis Permit is Approved by Public Works Date: (OK to Route to Other Departments) See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd ;,,_IA Separate PW Permit is Required (Permit#: PW -_ : ) Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND lx.: .:- located in this folder Chemical Sup: 0 Update Existing 0 New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ' Q(.� (4 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: 1 7V\ Date: 0 Public.Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: ///�9%i8 (7z7.