1502 100TH ST SW ELDANA AFH LLC 2021-12-13

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) 16 PERMIT # BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Ma a this a "W" Permit BI /TI/ ddn/Rem Size Garage/Accessory Struct. Size �S Number of Stories L- Basement No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System of Req'd Reason Sprinklers Required: Fire Alarm: []Update Existing ❑ New System -RNot Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ut No Add'I RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ ',,00- 00 Additional Notes: Approved B Date: aP r ly Z,Zr a 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: Date: 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-��,„�, Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Fin I? ❑Yes No "In Lieu" Fee: Type: Amou School Impact Fee: Total $ Calculated: Credit: , El Everett School Dist ❑Mukilteo Zhool Dist Additional Notes: Approved By: L, , Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: IPIN WorksheetNeeded if.• !OSys Dev Eval ❑Traffic Mit Eval =(]Site Work or Drainage Proposed sElBackflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, _supportive housing) .................... ............................. ._... ........... .... ....... .....Y_............... ..........,........,................,...., ❑ 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 folder for permit issuance) ❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: