9505 19TH AVE SE SAGE HOMES NW 2021-07-13

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY • PERMIT# �k-, ZQ03 ra) BUILDING PLANNING ,7 Intake OK by: Date: Intake OK by: avr, Assign To:A te4 Date: 3/o/2& Intake Comments: Intake Comments: k&O ❑ Ro to to Commercial Building ❑ Attach to Project No. ❑ oute to Residential Building 0 oute to Historic Reviewer Make this a"W"Permit ( OK to Route to Other Departments Bldg/TI/Addn/Rem Size / 3Z3 �f 0 Hold in Planning File Drawer Garage/Accessory Struct. Size ///4 Zone g-- I Number of Stories f Overlay/Agreement C CY10 " _ .CrZ�' Basement i❑No ❑Yes, Fin/Unfin Nonresidential Use A( C-e Type of Construction ii-Q Residential Use Occupancy Group 6 Proposed No.of Dwelling Units: Occupancy Load /3 Total No. of Dwelling Units: "'-- i Fire Sprinklers: ❑Update Existing El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Am nt$ Fire Alarm: El Update Existing El New System ®Not Req'd Sc of t Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 13 No ❑Everette Sc Ist ❑Mukilteo Sc ' t Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additior ai I Notes: VALUATION CALCULATION: Total$ 2 3/ 750.a0 Approved By: A?' t 4 7 Date: 4*StO PUBLIC WORKS Intake OK by: -i+4 Date: 0310 4 t2-026 Additional Notes: Intake Comments: PW Worksheet Needed if: M DI:"it a i"rw ';Ar e 43(el ='D Ir-1 2 +.t Sys Dev val ©Traffic Mit Eval S-tQ}`,� S-if(t-.P.wa G (]Site Work or Drainage ProposedWo gotL 4AA. Acr_cs5 Approved By ,,�� Date:03/0 9/�� ❑Backflow Prevention for high hazard: ;(dental,medical,animals,mortuary,hospital, [supportive housing) FIRE DEPARTMENT grFoute 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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 14 This Permit is Approved by Public Works 10 See PW Review Worksheet and associated attached items Fire Dept. Fees: r A Separate PW Permit is Required(Permit#: PW21,63-0 lS ) ❑ 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: 2)cot _N\ Date: 3-2 L/-o2Q?G ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: J Date: 03 tic/zicza?