1715 HOLBROOK AVE 2021-12-16 - Laserfiche WebLink

Intake &Approval Sheet fil (FOR PERMIT STAFF ONLY) 40 PERMIT# 1321 O3 - 0'6 • BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ 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 1JAVG Z1'' ❑ Hold in Planning File Drawer ._ Garage/Accessory Struct. Size Zone leA Number of Stories / Overlay/Agreement Basement In+No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction 172- - Residential Use ) 're— Occupancy Group V2C Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing El New System &ot Req'd Planning/Landscape Inspection Required before Final? ❑Yes,krNo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System riNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Ell Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes Ell No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: 42,AVALUATION CALCULATION: Total$ Ii0 '� � 8(Y-- drvi Approved By: 11-. 611, Date: '-& I 7s PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: 'PWWorksheet Needed if: I.DSys Dev Eval ❑Traffic Mit Eval . ilasite Work or Drainage Proposed / Approved By: Z-�r Date:!.1 A.....A., OBackflow Prevention for high hazard: 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: ❑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 coin 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: