6509 BROADWAY A 2021-12-20 - Laserfiche WebLink

Int.ke & Approval Sheet ill (FOR PERMIT ST4FF O ,LILY • PE"MIT#150-b —03 BUILDING i PLANNING . Intake OK by: Date: Intake OK by: Assign To: Date: /1-7/2-0 Intake Comments: ;Intake Comments: . 1-- `DUI ❑ Route to Commercial Building i❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer • ❑ Make this a"W"Permit I® OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size [Zone V_. Number of Stories 'Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use -- Type of Construction Residential Use III V I *OA/ Occupancy Group Proposed No.of Dwelling Units: Occupancy Load ;Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? DYes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes:Li ✓t VALUATION CALCULATION: Total$ 000,00eAoii PS e � I r ' �ltA, NO picirri _ Approved Byre Date: /1 / r PUBLIC WORKS Intake OK by: tit Date: i III 12-a 2-0 Additional Notes: Intake Comments: I PW Worksheet Needed if: NZ LAC-=- `�K' 6.1 i( Sys=Dev EvaI ❑Traffic Mit Eval s Sirwc.-„.,�.a` wtcam, IOSite Work or Drainage Proposed Approved Date:Q�j �D I OBackflow Prevention for high hazard: 7 '(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT El 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 El Fire Alarm El Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred Additional Notes: 3 ❑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 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 1% '.blic Works has no sco ---PW No Required Additional Noted-•� �� ' i'�2v Zp ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: