716 33RD ST 2021-12-16 - Laserfiche WebLink

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLr • PERMIT # ?j2005-005 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct.. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing El New System ❑Not 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 Add'I RCW 64.55 docs required prior to final? ❑Yes []No VALUATION CALCULATION: Total $ -9-00 Additional Notes: Z Qls lam— I w-s Approved By: Date: Z FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm []Other: 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: D te: �_ ► -_ - - - W PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Worksheet Needed if. []Sys Dev Eval ❑Traffic Mit Evai []Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: `(dental, medical, animals, mortuary, hospital, -supportive housing) e.............,.,..,...._.,_.,,...._......... _... ._....... _..................... ..,,....__........................._.. ❑ 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 Jr - ❑ 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 (join with this folder for permit issuance) ❑ WIII be issued separately (separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Re uire-� ditional Notes: ✓ �� G. e� �j� r Approved By: Date: