1406 MADRONA AVE 2020-12-31 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �k t 0C -0L BUILDING PLANNING Intake OK by: ( Date: C. /Z 2/2 Intake OK by:` Date: CO_tQ'-7 0 VC1 Intake Comments: Intake Comments: Assign To: A_ &l c& ❑ Route to Commercial Building N Attach to Project No. \,�t_ " OCY Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit ® OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garag Acces Struct. Size 1—e'4- S.r Zone Number of Stories / Overlay/Agreement Basement QNo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Ti-e7 Residential Use Occupancy Group LA Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: El Update Existing DNew System Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes allo ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes Er—No Additional Notes: VALUATION CALCULATION: Total $ ( 2.I 00 Approved By: Cif) Date: r:021/ PUBLIC WORKS Intake OK by: . 7 Date: el (( Additional Notes: �— -� ^C/�/� / C. Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ti�c DSite Work or Drainage Proposed Approved By: C )N Date: ''l I'� /�D ❑Backflow Prevention for high hazard: J (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers El Fire Alarm ❑Ott— AND ❑Create Green Folder ❑Submitted Previously ODeferred Additional Notes: 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: % ❑ A Separate PW Permit is Required (Permit#: PW ❑ Revie As-Built Plans- NO FIRE FEE AND ❑ Is located in this folder ❑ lnimal or No Fire Scope- NO FIRE FEE ❑ Is in a Separate Green Folder tom with this folder for permit issuance) El Review/Inspection Scope-ADD FIRE FEE El Will be issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By: Date: Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: