117 79TH PL SE 2021-11-08 - Laserfiche WebLink

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# j 2.1 0 9 '026 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 ^ ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size S Zone Number of Stories / Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Cite- Residential Use Occupancy Group 2',C Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: CI Update Existing El New System,Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing CI New System/3Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: r� Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes �Y No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes rallo Additional Notes: VALUATION CALCULATION: Total$,ODQ 0,2 z Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: OSys Dev Eval OTraffic Mit Eval I OSite Work or Drainage Proposed Approved By Date:0.rQ,/ Zoe/ IOBackflow Prevention for high hazard: :(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 ❑ 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: 09 lAln Date: j -,ZAI a,I ta Public Works has no scope---PW Not Required Additional Notes: ELECTRICALJ' Additional Notes: ��- ( ( / '12.,G I9.o 24 Approved By: Date: Approved By: Date: