1816 CEDAR ST 2022-01-25 - Laserfiche WebLink

Intake & Approval Sheet * (FOR PERMIT STAFF ONLY) 0 PERMIT #" 2-006—xf: BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Yakp this a "W" Permit Bld I ddn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement ®No ❑Yes , Fin / Unfin Type of Construction Va Occupancy Group �.— Occupancy LoadMT Fire Sprinklers: ❑Update Existing ❑New System of Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add1 RCW 64.55 does required prior to final? ❑Yes IRNo VALUATION CALCULATION: Total $ ��- Additional Notes: Approved B Date: O7 FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: day Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: 7. 5 v • —Ls- PUBLIC WORKS Intake OK by: Date: ........... W...... .... ......... .... .................. -..w...... ...... ........�...._.... _............. ...._.... Intake Comments: PIN Worksheet Needed if., ill Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: 3(dental, medical, animals, mortuary, hospital, isupportive housing) ...... ...... ,..... _ ..............................._...................... ...... ................... .................. ............ ............ ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder []Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder Coin with this folderfor permit issuance) ❑ Will be Issued separately (separate Green Folder, PW issued ahead of Bldg) R 'ublic Works has no scope --- PW Not Required Additional Note -7/, o ) Zo ?.c3 Approved By: Date: