1802 75TH ST SW 2021-12-30 - Laserfiche WebLink

Intake & Approval Sheet *(FOR PERMIT STAFF ONLY] 0 PERMIT # l,Ul l' dJQq. 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 ❑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] RCW 64.55 docs required prior to final? ❑Yes ❑ No VALUATION CALCULATION: Total $ Additional Notes: Approved By: J Date: 2 &X16 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:' � a Date;' " Intake Comments: N P,01 (5r_, e,91 S r- , pvw Vn 1 , ❑ Attach to Project No. ute to Historic Reviewer to Route to Other Departments VO ❑ Hold in Planning File Drawer Zone — Overlay/Agreement Nonresidential Use Glo-6) - Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes o "In Lieu" Fee: Type: Amount $ hool Imp t ee: Total $ Ealculat Credit: Ev eft School DikAMukilteo hoot,Dlst Additional Notes: Approved By a e., PUBLIC WORKS ` Intake OK by: Date: :,..,.,._..,. ... •.................................. .......•...... ........ .................... .................... -........ -..... ........ Intake Comments: PW Worksheet Needed if.• []Sys Dev Eva] ❑Traffic Mit Eval =Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, 3supportive housing) ............,.........,....,....,......,.....................,,.....,,....,...,...,..........,.,..,.,...,,,,,.. ❑ Route this folder for PW Review at end --- PW Review Worksheef ❑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 a ❑ 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 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: z�