10812 HOLLY DR 2021-11-12 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# Zaf®G - O 2-1 BUILDING PLANNING Intake OK by: Date: Intake OK by:() Assign To:M.6 g , Date: (a.Ic 2 2'1 Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ■ '+ute to Historic Reviewer ❑ Make this a"W"Permit n OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size A(, Zone Number of Stories / Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction .�yj G Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing El New System El 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 ONot Req'd School Impact Fee: Total $ 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 El No Additional Notes: VALUATION CALCULATION: Total$2 q j•7.S Approved By: (.NSA Date: llr•1 _ 262,1 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: `DSys Dev Eval ❑Traffic Mit Eval i❑Site Work or Drainage Proposed I]Backflow Prevention for high hazard: Approved By; \�� Date:0j,��g/ �i :(dental,medical,animals,mortuary,hospital, \./ :supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers OFire Alarm ❑Other: AND ❑Create 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: ❑ 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 By: Date: 2f7/