1925 73RD ST SE 2021-12-22 - Laserfiche WebLink

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) 0 PERMIT # Q�2po'g —()02..) 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 �yJ Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group 4'Z Occupancy Load Fire Sprinklers: ❑Update Existing El New System M Not Req'd Reason Sprinklers Required: Fire Alarm: El Update Existing ❑New System N Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes V3 No Add'] RCW 64.55 docs required prior to final? ❑Yes ®No VALUATION CALCULATION: Total $ CO ni 4 t $ a 5S x -1 I Additional Notes: Approved By: Date: t 3 ¢ pyp 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: Dater ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. Route to Historic Reviewer K 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: Planni /Landscape Inspection Required„fWo.re Final? ❑Yes No "In Lieu" Fee. e: Amount $ School Impact Fee: $ Calculated: redit: ❑Ev t School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: PUBLIC WORKS " Intake OK by: Date: _..................... ...... .........._..... _.._.....,......,................................_.... Intake Comments: PW Worksheet Needed if., ❑Sys Dev Eval ❑Traffic Mit Eval =OSite Work or Drainage Proposed ❑Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, ,supportive housing) .............................................. ..-... ................. ............. .................................... ......... I .......... .......... ❑ 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 21 This Permit is Approved by Public Works " 9See 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 folderfor 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: t0 :�O