2101 LEXINGTON AVE 2021-09-24 - Laserfiche WebLink

• • �� J Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# ) � —O A 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/Addklem ze TOO ,v f (7.t A ROB, ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Vi5 Residential Use Occupancy Group 3 Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: El Update Existing ONew System ?lot Req'd Planning/Landscape Inspection Required before Final? ❑Yes.cNo Reason Sprinklers Required: / "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ❑New System,Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 5 No ❑Everett School Dist ❑Mukilteo School Dist Add!RCW 64.55 docs required prior to final? El Yes ....121vo Additional Notes: VALUATION CALCULATION: Total$S aoe . cL • Approved By�-� �r Date: 7 , f PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: €❑Sys Dev Eval ❑Traffic Mit Eval El Site Work or Drainage Proposed Approved B Date: '/G// .i, I❑Backflow Prevention for high hazard: eer I(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT El 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 El Other: AND OCreate Green Folder OSubmitted 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) ❑ 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 B (T Date: 562J0 Z 1 r_c, ,,4)