2111 JACKSON AVE 2021-11-15 - Laserfiche WebLink

A • Intake 8 Approval Sheet (FOR PERMIT STAFF ONL l) PERMIT#Z UO2 o3' BUILDING PLANNING . . Intake OK by: Date: Intake OK by:M Assign To: . A,f Date: Zf Z\_I Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 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 1 1/1/4-- ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size ..-- Zone e--,- 2- Number of Stories / Overlay/Agreement - Basement ONo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction .6.7/C Residential Use S Fr- Occupancy Group Proposed No.of Dwelling Units: --- Occupancy Load - YG� Total No.of Dwelling Units: 2- Fire Sprinklers: ❑Update Existing ❑New System Utdot Req'd Planning/Landscape Inspection Required before Final? ❑Yes 324No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System PNot Req'd School Im ac Fee: T al-I /\ Reason Fire Alarm Required: Calk}Ilate : C dit: \ RCW 64.55 MF worksheet req'd for permit? ❑Yes 11No ❑Erj t School 1st ❑Mukifteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ONo Additional Notes: IYs—xlor kNCf ,✓1 ex.:c in 5ff-aAly VALUATION CALCULATION: Total$ 0°4-1 Approved By '(' Date: ;_f`3e?-9,-f PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: i IPW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval s❑Site Work or Drainage Proposed Approved By: 1� �- Date:,/ e / i❑Backflow 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) OFire Sprinklers ❑Fire 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 0 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: