6214 BROADWAY 2021-12-23 - Laserfiche WebLink

Intake & Approval Sheet (*(FOR PERMIT STAFF ONLY) 0 PERMIT # WbDS-0 6U BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Z /,70SIT- Garage/Accessory Struct. Size ff Number of Stories Basement No Yes , in Unfin Type of Construction � {3 Occupancy Group le — 3 Occupancy Load 6 Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes B No Add'( RCW 64.55 docs required prior to final? ❑Yes 19 No VALUATION CALCULATION: Total $ ZZ.S Deo, DU Additional Notes: Approved By Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: El Fire Sprinklers ❑Fire Alarm []Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: -- Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes OTNO "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes* �lv�y A„�uJ�{Vp�jJ�-^,-'^y �, aL � CW- _ Z N �W f m'4 'ACM ^^ " Approved By: Date: PUBLIC WORKS Intake OK by: Date: r......_..___..........._._._....,.......,.,......_............ .... ..... ....... ..................... Intake Comments: PIN Worksheet Needed if: I El Sys Dev Eval ❑Traffic Mit Eval € []Site Work or Drainage Proposed �Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, %supportive housing) _....._.........._......_..._..._....._..... _.......... _......._.... _........_ ❑Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works " ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ Will be issued separately (separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: p