2416 CLEVELAND AVE B 2021-12-22 - Laserfiche WebLink

! a Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#an0ct r-cog 1 , AlBUILDING PLANNING Intake OK by: �" Date: 6i 7 Intake OK by: � Date: Ci r I Z- ) W Intake Comments: Intake Comments: Assign To: V...•- () b {e).A42,---6 C-cc AV +JS r y)-;1l ► ac.l ( '15^� a- C¢/ ccr.A-11)- % ❑ Route to Commercial Building 0 Attach to Project No. Er Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit OK to Route to Other Departments ljl/Addn/Rem Size 6 ;.p SP Hold in Planning File Drawer Garage/Accessory Struct. Size 0"_ Zone ''-Z Number of Stories Z.. Overlay/Agreement Basement ETNo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction 'Zs Residential Use (34 t 1 5 a- Occupancy Group Proposed No. of Dwelling Units: A OA'OU c-OL) Occupancy Load Total No. of Dwelling Units: 1.- ', i. 4. '1. DAD..) Fire Sprinklers: ❑Update Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes..ZINo Reason Sprinklers Required: "In Lieu" Fee:Type: Amount Fire Alarm: ❑Update Existing ❑New System ONot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit/" RCW 64.55 MF worksheet req'd for permit? ❑Yes Er No ❑Everett School Dist ❑Mukilteo chool Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: �j,,,� �� i- ' (�_ VALUATION CALCULATION: Total $ 711 e:' (.7 \ ft„„ �Juawo"`�'� tp KJ��1 —xi G Ct�O� 7.L2.Z . .2„A 3S't @ ( 2,-1 G @ t z l Approved By: 11,4 211Date: 1?jZejZ�J PUBLIC WORKS Intake OK by: - '''--I Date: `r : . !. - (r Additional Notes: Zo/ g t c + NSieC Intake Comments: PW Worksheet Needed if: -?'Ro?a$SE: '.DA b ' s rr_r+ Sys Dev Eval DTraffic Mit Eval i P4N-NIIC.. � K% — s Site Work or Drainage Proposed Approved By: (J O' Date: 44-9/2o v-fc.. ❑Backflow Prevention for high hazard: 3 s 4 )0.- Hof ,i4,a,fai, (dental,medical,animals,mortuary,hospital, S 4 4 1 .P," L A 4,1, supportive housing) FIRE DEPARTMENT y 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) OFire Sprinklers ❑Fire Alarm ❑Other: _ _ AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: This Permit is Approved by Public Works fff-see PW Review Worksheet and associated attached items Fire Dept. Fees: ®-A Separate PW Permit is Required (Permit#: PW (9 1 1 - ooz ) ❑ Review of As-Built Plans- NO FIRE FEE AND IA 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: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: i Approved By: Date: Approved — Date: (! 0 4-lib f`/