525 112TH ST SE 2021-11-08 - Laserfiche WebLink

• Intake & Approval Sheet (FOR PERMIT STAFF ONLY) II/ qO lS PERMIT#J A -0(9. BUILDING PLANNING Intake OK by: Date: e7 it(4/ Intake OK by:j)1 Date: b(7/1 Intake Comments it ? _qt�� fog �CJt`71 Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit in OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone -- Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Ct Type of Construction Residential Use n/l, Occupancy Group Proposed No.of Dwelling Units: 0 A Occupancy Load Total No.of Dwelling Units: 0/ Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes,'No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $31 Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ a500 Approved By: Mips Date: f,/.7„( /(it PUBLIC WORKS Intake OK by: Date: )31.512.01 q Additional Notes: `V7-c'at. '�-P Ct-Xl A-VeaI� Intake Comments: PW Worksheet Needed if:AtOWe- -7.=*4L►f µewe eE t Ikc\AE`, n ❑Sys Dev Eval ❑Traffic Mit Eval 1 J u I t S-0' OSite Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By: ,0-�00'. Date: e:,)l q/I-c7 (dental,medical,animals,mortuary,hospital, l supportive housing) FIRE DEPARTMENT DRoute 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 OFire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 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 0 Is in a Separate Green Folder Goin with this folder for permit issuance) 0 Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: ,�jrdc,t/r) Date: 9.t-5 lrf ublic Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Qom Approved By: Date: Approved By: Q .S ` Date: 7-111 ci