5631 10TH DR W 2021-09-02 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) . PERMIT# 'i-:?jkCA0q r02- BUILDING PLANNING Intake OK by: Date: 7/1 q/(/ Intake OK by: A45 Date: i/t eL f i- 1 Intake Comments: Intake Comments: Assign To: ,t o Route to Commercial Building ❑Attach to Project No. 53 Route to Residential Building ❑ oute to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/ ccesso Struct. Size 2'to s.g Zone 1?--�j Number of Stories Overlay/Agreement '6'.-`' C01'l'E ( zoYu. Basement ❑No Oyes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Proposed No. of Dwelling Units: ! g 50 -50640 Total No.of Dwelling Units: 1 INew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes to 1 C. 25 &CO ❑ "In Lieu"Fee:Type: Amount$ �� I ' New System Not Req'd School Impact Fee: To I ? INew �kD Calculated: Credit: I 7 it? Oyes 0 No ❑Ev School Dist ❑Mukilteo School Dist /- r �. ,w icyuncu Nuvrzv unai? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Tot4l Z6 69/ Approved By: /•f Date: q/( ( l el ll� PUBLIC WORKS t Intake OK by: i ts.\ Date: 7 J 1 g)2)1 S. Additional Notes: 2ois Intake Comments: PW Worksheet Needed if: ��6._ eov E��o ❑Sys Dev Eva! ❑Traffic Mit Eval A6 w(Irrsia• N£ t_css -n .� • 2v o ❑Site Work or Drainage Proposed Approved B �� Date: p�2/ZOZ o �+c+ +w;3 L.. �Nu 2r-S OBackflow Prevention for high hazard: r�GoP (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder aoin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE , � El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: LLI Public Works has no scope---PW Not equired Additional Notes: ELECTRICAL -7/I`t 1�i 9 Additional Notes: Approved By: Date: Approved By: Date: v6