916 PACIFIC AVE BASE FILE 2021-12-10

• 6 Intake & Approval Sheet - (FOR PERMIT STAFF ONLr PERMIT# J Y ( D BUILDING PLANNING Intake OK by e Date: 000/ Intake OK by: Date: Intake Comments: Intake Comments: Assign To: u i26 rt- ry 0 ✓' ❑ Route to Commercial Building ❑ Attach to Project No. El Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldge\ddn/Rem Size /6O £S'F 0 Hold in Planning File Drawer Garage/Accessory Struct.Size AI/�4 Zone Number of Stories Overlay/Agreement Basement to ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group I- Z Proposed No. of Dwelling Units: Occupancy Load 2-, Total No. of Dwelling Units: Fire Sprinklers:,®Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo Reason Sprinklers Required , _ "In Lieu" Fee:Type: —Amount$ Fire Alarm: Update Existing ❑New System ❑Not Req'd School Impact Fee: To Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No ❑E t School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? Yes ElNo Additional Notes: • VALUATION CALCULATION: Total$ 71 d00•lD +Ii-jc or eP 1 SIi,i 6) -V ) )V✓. ItCC�� annT Approved By: Date: 0/ '/t-I PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By(,d_,Aft- Date: Q,+ (f 7/21/9 (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) ❑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 ) El Review of As-Built Plans- NO F ' FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope I FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Sco --ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: lA Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional No -s: Approved/6y: � Date:46/0-740g Approved By: Date: