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16 76TH ST SW 2021-12-30
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16 76TH ST SW 2021-12-30
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Last modified
12/30/2021 12:22:46 PM
Creation date
11/10/2021 11:03:56 AM
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Address Document
Street Name
76TH ST SW
Street Number
16
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Intake & Approval Sheet db (FOR PERMIT STAFF ONLY 0 PERMIT # <br />BUILDING <br />Intake OK by: Date: Z� <br />Intake Comments: <br />❑ Route to Commercial Building <br />0 Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldglfl/Add em ize <br />.FG S <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />UNo ❑Yes , Fin / Unfin <br />Type of Construction <br />�-- <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: []Update Existing ❑New System PNot Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: El Update Existing []New System ®Not Req'd <br />Reason Fire Alarm Required: <br />�t <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes tR No <br />Add'I RCW 64.55 docs required prior to final? []Yes RNo <br />VALUATION CALCULATION: Total $ 7,71731 <br />Additional Notes: 2 0 1 .6- f 12C.Se- <br />Approved By. Date: .212 Zo <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ❑Fire Alarm []Other: <br />5 <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />❑ Minimal or No Fire Scope - NO FIRE FEE <br />❑ Review / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: YAt Assign To: f+- Date: Z--' IZ-7_0 <br />Intake Comments: <br />w j b CAam- roor,s <br />❑ Attach to Project No. <br />G <br />❑ Route to Historic Reviewer <br />WK to Route to Other Departments <br />LJ Hold in Planning File Drawer <br />Zone <br />12,1 <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />� h <br />Proposed No. of Dwelling Units: <br />-� <br />Total No. of Dwelling Units: <br />'. <br />Planning/Landscape Inspection Required before Final? ❑Yes 15140 <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Di <br />Additional Notes: <br />,plaq 5 <br />Approved By: Date: -Z , l I,ZOw <br />PUBLIC WORKS <br />Intake OK by: Date: <br />W p _ .,_........_.._....._............. ....................................... <br />Intake Comments: r PW Worksheet Needed if." <br />'9Sys Dev EvalsO []Traffic Mit Eval N° <br />S $/ A�UFQSite Work Qd. <br />1013ackflow Prevention for high hazard: <br />;(dental, medical, animals, mortuary, hospital, <br />Q ` r%j :supportive housing) <br />.. .... ....... ........................... -.................. ...........».............. ........ ................... <br />o toe Is oiaer ro t-vv mOviGv la, 'a --- PW Review Worksheet <br />[]This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder []Submitted Previously ❑Deferred <br />❑ This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />1AA Separate PW Permit is Required (Permit #: PW <br />AND ,ls located in this folder <br />❑ Is in a Separate Green Folder (join with this folder for permit issuance) <br />❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes - <br />Approved By::L <br />Date: IZ /1 jW <br />
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