712 91ST PL SE 2022-01-11 - Laserfiche WebLink

� Rr�5,b4 A-C-� � Intake & Approval Sheet (FOR PERMIT STAFF ONLV) PERMIT # C1g0_7-0Q_7 BUILDING Intake OK by: Date: 2. 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 El 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 $ Additional Notes: 2 b f S" l2C tv S 6C_ Approved By: Date: o Z 0 - 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 1 Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by:_-W Assign To:Date: • Z-7 Intake Comments: r� q ❑ Attach to Project No. ❑ Route to Historic Reviewer IOK to Route to Other Departments D 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: PUBLIC WORKS Intake OK by: 24 Date: %s -77 .......................................................................,,..,.............................................. 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, ?supportive housing) c............ ........ ................... ......... ........ . �......... _ _........................ _......... _....................... .......... . _. ❑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 (join with this folderfor permit issuance) ❑ Will be issued separately s reen Folder, PW issued ahead of Bldg) Public Works has no scope - PW Not Required Additional Notes: [Approved By: Date: �l