2324 100TH ST SE 2021-12-13 - Laserfiche WebLink

�r�o,\ Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLI�• PERMIT # -4 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ER,ftoute to Residential Building ❑ Make this a "W" Permit Bldg/TI/Add Size Garage/Accessory Struct. Size Number of Stories Basement o ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load — — -- - AJIA Fire Sprinklers: El Update Existing El New System WNot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System ANot 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 BNo VALUATION CALCULATION: Total $_4" -A'_ .? 577- q L Additional Notes: 41 Approved By: Date: &J13 - 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: r .E tL J v1 Date: / ,I g ;2020 ELECTRICAL Additional Notes: Approved By: Date: PLANNING,," Intake OK b Assign ToDate: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use *'Ic- S� Proposed No. of Dwelling Units: Total No. of Dwelling Units: - ------ ---- - - _ -_ Planning/Landscape Inspection Required before Fi []Yes []No "In Lieu" Fee: Type: A nt $ School Impact Fee: Total $ Calculated: C dit: ❑Everett School Dist ❑Mu teo School Dist Additional Notes: Approved B Date: PUBLIC WORKS Intake OK by: -f*Date: 77T <j a -.._..,,,_............. ........ ,...._........w,.._,,.,._........,......,.......................... Intake Comments: PW Worksheet Needed if.• ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, ;supportive housing) .................................................................................................................................................... []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 his Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ET�A Separate PW Permit is Required (Permit #: PW elo6 S O AND ❑ Is located in this folder ❑ Is in a Separate Green Folder Qoin 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: C�)