3406 NORTON AVE 2022-02-24 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ON09• PERMIT # C t f1-_ 6t 00 BUILDING Intake OK by: Date: —��— Intake Comments: ❑ Route to Commercial Building FR Route to Residential Building ❑ Make this a "W" Permit Bldg/TI d em ize s Z OC7 Garage/Accessory Struct. Size Number of Stories Basement ❑No (Wes, Fin / nfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System []Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing El New System ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No VALUATION CALCULATION: Total $, Z,0, to,2-4 Z Additional Notes: Z OIG Igr �t- wSjgG. $ `('eUl�lohs Approved By: Datim• FIRE. DEPARTMENT - Separate / Deferred Submittals Required: ❑Fire Sprinklers El 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: Date: 9 Intake Comments: Assign To: )(N0xW9tfV30cc �cw.ed v� his rt �e�� re e� bcc.�C ks *gs&tvedr�)404 ❑ Attach to Project No. S.& Route to Historic Reviewer OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone 1 Overlay/Agreement Nonresidential Use Residential Use c J� Proposed No. of Dwelling Units: Total No. of Dwelling Units: GJ�e Planning/Landscape Inspection Required before Final? ❑Yes T]No "in Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist Mukilteo School Dist Additional Notes: Approved Date: PUBLIC WORKS Intake OK by: Date: ------------------- ---- ----------------- Intake Comments: ;PWWorksheetNeededif. • El Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed I]Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, ;supportive housing) ❑ Route 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) ❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) QdPublic Works has no scope --- PW Not Required Additional Notes: �aA;�AOY - ft6t 4AA V4. Approved By: Date: