12800 19TH AVE SE 2021-02-23 - Laserfiche WebLink

Intake & Approval Sheet 411) (FOR PERMIT STAFF ONLY) PERMIT# 6)1 05---6--)1, BUILDING PLANNING Intake OK by: Date:�✓/�41 11 Intake OK by: Date: 5/ �4,//I 7 Intake Comm nt Intake Comments: Assign To: id W)� ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 14 OK to Route to Other Departments Bldddn/Rem Size 2,4S ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size �� Zone C— Number of Stories 2— Overlay/Agreement Basement KINo ❑Yes , Fin/Unfin Nonresidential Use f'l-L{L(i °t C( 1 G T o Type of Construction .274 Residential Use ----_, Occupancy Group ,Q Proposed No. of Dwelling Units: Occupancy Load //A Total No. of Dwelling Units: Fire Sprinklers: ❑' .Update Existing llNew System DNot Req'd Planning/Landscape Inspection Required before Final? ❑YesNo Reason Sprinkle Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: J 11Jpdate Existing ❑New System El Not Req'd School Impact Fee: Tot Reason Fire Alarm Required: Calculated: Credit: RCW �I 64.55 MF worksheet req'd for permit? DYes 2 u No ❑Everett Sch Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes GIIINo Additional otes: VALUATION CALCULATION: Total $ S U 00.UO _,- Approved ij Date: / 1- / ) cri By: /' `> PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval DTraffic Mit Eval Site Work or Draina.- Proposed A roved B / ❑Backflow Preve for high hazard: PP I., `s l Date: C y �� (dental,medics : imals,mortuary,hospital, supportive .using) FIRE DEPARTMENT ❑Route this folder for PW Review at --: ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separa - concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folde ■Submitted Previously ❑Deferred Additional Notes: ❑ This Permit is Appr.•ed by Public Works ❑ See PW Revie orksheet and associated attached items Fire Dept. Fees: ❑ A Separate • Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ I ocated in this folder IMinimal or No Fire Scope- NO FIRE FEE ■ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ill Will be issued separa eparate ree der,PW issued ahead of Bldg) Approved By:__ /�� Date: SIZE /7 Public Works has no sco ---PW Not Required / Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: (fiD