3403 W MUKILTEO BLVD 2021-06-10 - Laserfiche WebLink

• Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT#0 l et V"1 -ON BUILDING PLANNING Intake OK by: 44-1—' Date: 4l3/t 9 Intake OK by: Date: % l ((e1 Intake Comments: Intake Comments: Assign To: 3 ( C 5 1, N VSrk_ ❑ Route to Commercial Building Attach to Project No. Ri-V ( 1 " 40 ,,Route to Residential Building ❑ to to iotorio Rev ieweweY ❑ Make this a"W"Permit gOK to Route to Other Departments Bldg/TUAddry el ize -leld in-Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No Oyes, Fin/Unfin Nonresidential Use I,) Type of Construction Residential Use `i S Occupancy Group Proposed No. of Dwelling Units: I pv—P Occupancy Load Total No. of Dwelling Units: t fi k A-1-Jt. Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes '�No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: in/( v t PUBLIC WORKS / Intake OK by: Date: Additional Notes: /S /,/1,.0 W SfA G Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Mite Work or Drainage Proposed Approved By: Cft(". Date: 61211R ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: F1 This Permit is Approved by Public Works See PW Review Worksheet and associated attached items Fire Dept. Fees: Separate PW Permit is Required (Permit#: PW / 70(o-O 13 ) ❑ Review of As-Built Plans-NO FIRE FEE AND Jig-Is located in this folder ❑ Minimal 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 ❑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 ti. 7 77,,o) Date: (077 cs)42).