2001 120TH PL SE 2021-12-14 - Laserfiche WebLink

cc Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Add i e ,l2F/_OC%� Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group IleZ Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System El Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? 3Yes ❑ No Add'I RCW 64.55 docs required prior to final?c,-3Yes []No VALUATION CALCULATION: Total $ /c Gri(5 Additional Notes: Approved By- Date: OFA FIRE DEPARTMENT Separate / Deferred Submittals Required: El Fire Sprinklers ❑Fire Alarm []Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING' Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone — Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before F❑Yes ❑No "in Lieu" Fee: Type: ount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dis ❑Mukilteo School Dist Additional Notes. Approved By: Date: S; 0!ZC,,L4W PUBLIC WORKS Intake OK by: Date: .......,..,............................ ..... ...... ......... ....... ,.... ...... ..... .... ........... ..... ....... .... ....... ..... ..... ..... Intake Comments: -PW Worksheet Needed if., ,[]Sys Dev Eval []Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: .(dental, medical, animals, mortuary, hospital, =supportive housing) ................... ............ .. . ... ........ ........ ElRoute this folder for PW Review at end --- ....PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: