840 N BROADWAY B 2021-07-12 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 0 01"®OLk BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ 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 V \ Bldgffl/Addn/Rem Size ❑ Hold in Planning File Drawer //7"--Th Garage/Accessory Struct.Size Zone ` ,^�j Number of Stories Overlay/Agreement ��v �� Basement ❑No ❑Yes,. Fin/Unfin Nonresidential Use � �� Type of Construction Residential Use ` Occupancy Group Proposed No. of Dwelling Unit Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape In ection 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 0 No ❑Everett Sch,dol Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Ndes: VALUATION CALCULATION: Total$ 3ePt Co Approved By: Date: i PUBLIC WORKS j Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed - /_/ ❑Backflow Prevention for high hazard: III Approved By: fy Date: (dental,medical,animals,mortuary,hospital, 11 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) ❑Fire Sprinklers ❑Fire Alarm El other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: / 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: 7// ❑A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Pla I-NO FIRE FEE AND 0 Is located in this folder ❑ Minimal or No Fir cope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Review/Insp tion Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:k. P cc,A,n Date: 3—/q 0 Public Works has no scope---PW Not Required Additional Notes: Uptivaurron sfhois eJ.£Ck-.�f F e DA-/01S> ELECTRICAL N cuf sll . " e'e L ��- tz c'- k S —'-4-Cyoot, Additional Notes: elipG Jk to-, - t t i,v.ti Approved By: Date: Approved By: i Date: /0� (O f 3