4841 GLENWOOD AVE 2021-06-09 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT IlYt,JlA3 ‘ lO ,—04 BUILDING 1 PLANNING Intake OK byyA- Date:0/12-7/ZO/q Intake OK by: 1\ Assign To: T1`S Date: .CT•Z1.1 9 Intake Comments: Intake Comments: IT TV 02-ei./ , .r02 Nee., +v rvA_2b3 of 6i. C/�"4,&,t,246 /LCl/Lesi ❑ Route to Commercial Building ❑ Attach to Project No. � `oute to Residential Building El Route to Historic Reviewer ake this a"W"Permit *.OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone e.- '1 Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use 5 - Occupancy Group Proposed No.of Dwelling Units: -- Occupancy Load Total No.of Dwelling Units: 1— Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes tilNo Reason Sprinklers Required: "In Lieu"Fee:Type: /mixt<$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated:RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑ Dist Add'I RCW 64.55 dots required prior to final? ❑Yes ❑No Additional Notes: lJ 5 e-e- (s-e..o ;�ryv:�S t6t1-Aik5 oP VALUATION CALCULATION: Total$ I.AO.' 6 /avw �y.a., .5 -ro c I�-tr� T s%"- tray r s K°r Q1 -I & Ian Approved y: 'k .j Date: 10. I( . 19 PUBLIC WORKS n Intake OK by:%` Date: cl((Z-7 (ten, Additional Notes: Intake Comments: I PW Worksheet Needed if: 1 I TCaw-+,,�-f"6t hu Y f 61901 I DSys Dev Eval OTraffic Mit Eval 04'4 vr-CAN Sr-e plan �'OSite Work or Drainage Proposed Approved By: Date: (�(Qv k� �/e 0Backflow Prevention for high hazard: ;(dental,medical,animals,mortuary,hospital, [supportive housing) FIRE DEPARTMENT ❑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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 'TF"iis 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 ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder coin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: � Approved By: Date: Approved By ,�_ll Date: /o/Zg /,