2215 PINE ST 2021-12-10 - Laserfiche WebLink

• Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#V 1 t d�.00P BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No Oyes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: DUpdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: DUpdate Existing ONew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? Dyes ❑ No DEverett School Dist ❑Mukilteo School Dist Add'!RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: VALUATION CALCULATION: Total$ trt ADA' r‘ec et aL ih ‘(/I i virt(iC61) Approved By: Date: 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 .�.' Date: �Zp t DBackflow Prevention for high hazard: Approved By: I (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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works ❑ 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 ► . inimal 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 " i2P'j 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: $l 1('i- 'Public Works has no scope---PW Not Required ditional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: