10817 HOLLY DR 2021-12-22 - Laserfiche WebLink

• Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# w�� BUILDING PLANNING Intake OK by: c <t Date: I 2/51t9 Intake OK Assign To: . Date: t2-O S-l9_ Intake Comments: Intake Comments: 5 c..VeAN kokAz inn ❑ 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 ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use NNiA.o.,rn Y it Occupancy Group Proposed No.of Dwelling Units: 1 Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System El Not Req'd Planning/Landscape Inspection Required before Final", ❑Yes ®No Reason Sprinklers Required: "In Lieu"Fee:Type: Amou Fire Alarm: ❑Update Existing ❑New System CI Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr t: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No El Everett School Dist ❑Muki o School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ 5C00 �Na Approved BL�✓ Date: 2 S. ? 5te PUBLIC WORKS Intake OK by: Date: /2Ys Additional Notes: Intake Comments: iPW Worksheet Needed if: i®Sys Dev Eval ❑Traffic Mit Eval C of�' __ - �f:2"i Site Work or Drainage Proposed Approved By: Date: 43/09 /�' `(]Backflow Prevention for high hazard: _(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) El Fire Sprinklers El Fire Alarm ❑Other: AND Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: rAt 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 ❑ 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 ❑ 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: , - A_ Date: Z pp pp t� pi- 7v?c5