2505 57TH ST SW 2021-12-20 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONL� • PERMIT # G `" d� 1 BUILDING Intake OK by: Date: cs Intake Comments: ❑ Route to Commercial Building 0 Route to Residential Building ❑ Make this a "W" Permit Bldg/TI Rem Size Garage/Accessory Struct. Size �( Number of Stories Basement 15�No E]Y-es , Fin / Unfin Type of Construction .yL Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: []Update Existing []New System El Not Req'd Reason Fire Alarm Required: rrvptt RCW 64.55 MF worksheet req'd for permit? ❑Yes Z No Add'I RCW 64.55 docs required prior to final? ❑Yes 2No VALUATION CALCULATION: Total $ 33+ 5e'7 Additional Notes: Z O /S' fFX_ Gesso—c- Approved By: Date: 2- FIRE DEPARTMENT Separate / Deferred Submittals Required: El 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: Date: Intake Comments: Assign To: `\ 110-0 f qfPr f eq, xvvA ❑ Attach to Project No. ❑ Route to Historic Reviewer .OK to Route to Other Departments ' V. M E9Hold 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: N 0% Amount $ School Impact Fee: Total $ p * Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes:' cj � �� , Gam ^ r�Lonvr�ar%,►^, (Ito COJ QV�U — r4*, Approved By: Date: 7r, FM PUBLIC WORKS Intake OK by: Date: ZC'1 - ------ ------ ---------- Intake Comments: ;PW Worksheet Needed if: S� ;�',sys bev Eval ❑Traffic Mit Eval Sf add�`� OSite Work or Drainage Proposed :l]Backflow Prevention for high hazard: f:(dental, medical, animals, mortuary, hospital, sw Sys � "�. :supportive housing) gRoute 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 El 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 (Join with this folder for permit issuance) ❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: !/