7621 BEVERLY LN 2021-07-12 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# '12200 0( I BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ) /r6 4'F ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size A/jd Zone Z.— Number of Stories / Overlay/Agreement Basement EI_No ❑Yes ,' Fin I Unfin Nonresidential Use Sc4ci&cl Type of Construction J� Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load ys Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System IENot Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing RINew System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes r sa No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ,C_1No Additional Notes: VALUATION CALCULATION: Total$ Z3O 0, Approved By: , i/(7 Date: 1-1-/fj/e j I PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: I PW Worksheet Needed if: ❑Sys Dev Eval DTraffic Mit Eval I0Site Work or Drainage Proposed Approved B y2ti� Date:p�Z7,zpZp ❑Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT El 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) Mire Sprinklers EfFire Alarm ❑Other: AND El Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ This Permit is Approved by Public Works 0 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(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: \<,12,,n l(1 Date: 41.---/ziwaz 0 Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: