8621 XAVIER WAY 2021-07-13 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# -0L� BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bld 1/3ddn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size AI//1,4 Zone , Number of Stories / Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction f J Residential Use ,,OW CatitANNti Occupancy Group 2-3 Proposed No.of Dwelling Units: Occupancy Load 6 Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System ®Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Of° Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System lEINot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: nn 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 C LCULATION: Total $ /�68O,00 (!, teNt eel civ 1065 too ,,'T &= Goo(' /oxti) X 7/ = S6 g� Approved By: 1L.� LZ�� Date: 3.,,tc. 'Z4 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval i❑Site Work or Drainage Proposed Approved B Date:o/X.021 1❑Backf]ow Prevention for high hazard: / :(dental,medical,animals,mortuary,hospital, isupportive housing) i 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) El Fire Sprinklers El Fire Alarm ❑Other: AND ❑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: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 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 0 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 Su_ •V 2.tcM—oc \-- Additional Notes: Approved By: Date: Approved By:� Date: 4-2— 21