1722 HOLBROOK AVE 2021-09-24 - Laserfiche WebLink

intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# IJ 2 t o 6— b O5 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size /t20 ,J`,P ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size {''l.S Zone le-1 Number of Stories f Overlay/Agreement _ Basement 'Milo ❑Yes , Fin/Unfin Nonresidential Use Tyke of Construction g/e Residential Use Occupancy Group Z"LC Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: V Fire Sprinklers: El Update Existing ONew System ' Not Req'd Planning/Landscape Inspection Required bef a Final? ❑Ye No Reason Sprinklers Required: "In Lieu"Fee:Type: ount$ Fire Alarm: El Update Existing El New System/Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Calculated: Cre : RCW 64.55 MF worksheet req'd for permit? ❑ ,r5 Yes No ❑Everett School Dist ❑Mukilte School Dist Add!RCW 64.55 docs required prior to final? ❑Yes - No Additional Notes: , W � —VALUAI ION GALGULAI IUN: Total$ /0 O&& ,1406n Approved By: \L., Date: L. P LIC WORKS- Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: DSys Dev Eval ❑Traffic Mit Eval • ❑Site Work or Drainage Proposed Approved B Date p3- `OBackflow Prevention for high hazard: ' i(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) El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑This Permit is Approved by Public Works ❑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(join with this folder for permit issuance) El Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green-Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: /Z--