10105 1ST DR SE 2021-12-14 - Laserfiche WebLink

Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLY • PERMIT # 0, n � U CA BUILDING Intake OK by: Date: 1.0 1/7144_ Intake Comments: ❑ Route to Commercial Building ®.Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Z 3 Garage/Accessory Struct. Size Number of Stories Basement RNo ❑Yes , Fin / Unfin Type of Construction Occupancy Group i2 Occupancy Load Fire Sprinklers: El Update Existing ❑New System El Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes a No Add'I RCW 64.55 docs required prior to final? []Yes ERNo VALUATION CALCULATION: Total 2 17172 e 12l (01 'a &, " I .S-6 P. 3 D Additional Notes: 20 /5' iac- * to 16c. Approved By: Date: 1112 FIRE DEPARTMENT Separate / Deferred Submittals Required: fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: 1D \� 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 iApprovedBy: Date: s ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: V'oc Date: \ Intake Comments: I Attach to Project No. �,G \I �v\ " QAI ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement pc, Nonresidential Use Residential Use S Proposed No. of Dwelling Units: aJ -s2 Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist Mukilteo School Dist Additional Notes: [Approved By Date: J 'O, 2 YLQ• PUBLIC WORKS Intake OK by: —T t-k Date: ro IZ FS I I g ......................................................................................................................................., .,.. Intake Comments: PW Worksheet Needed if.• ❑Sys Dev Eva ❑Traffic Mit Eval L `y El Site Work or Drainage Proposed n1�w IP�.�cL3 �.• 4 q d.S � s ❑Backflow Prevention for high hazard: ��l�.Q o►vE �� ;(dental, medical, animals, mortuary, hospital, ,,supportive housing) rCLo+l 3 ¢............................................................................................................................................................. ❑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 El -A -Separate PW Permit is Required (Permit #: PW � ! i Z- ' C ?� ) AND 0 4s located in this folder ❑ Is in a Separate Green Folder Qoin with this folderfor permit issuance) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved Bye Date: