844 OLYMPIC BLVD 2022-01-20 - Laserfiche WebLink

II Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# CIJ..> - -- BUILDING PLANNING PLANNING Intake OK by: dti" Date: to/*C19 Intake OK by: \kW Assign To: Y--e Date: !O.3 -VI Intake Comments: Intake Comments: 3 ❑ Route to Commercial Building ❑ Attach to Project No. Route to Residential Building ❑ Route to Historic Reviewer Make this a"W"Permit LI`OK to Route to Other Departments Bldg/TI/Add em ize 23if S'W ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size 59 f Zone 9— Number of Stories Z Overlay/Agreement Basement No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction 7_g Residential Use (50,66,0 Occupancy Group RAI Proposed No.of Dwelling Units: ^�1 Occupancy Load Total No.of Dwelling Units: '_1.. Fire Sprinklers: ❑Update Existing Chew System IFINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes'No Reason Sprinklers Required: "In Lieu"Fee:Type: '• ount$ Fire Alarm: CI Update Existing El New System ®Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr:4 it: RCW 64.55 MF worksheet req'd for permit? ❑Yes Et No ❑Everett School Dist ❑Mukil i a School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: ac. (\ _ I 5i` e. VALUATION CALCULATION: Total$ 3? 7C76 f�G� �ow— CokV. Cw4.4.t6G Approved By: Y. 1 Date: lZ-6-Iq 59 q G is/so AAA., prcK PUBLIC WORKS 2'S6 Gr 2575/5 Intake OK by: r I4 Date: lb 1.3 I Zo t ci Additional Notes: 20/S inc... #§ //1fis - Intake Comments: PW Worksheet Needed if: �aJC.vs 's.toe'oc.ac �o a.tu ' Sys Dev Eval ❑Traffic Mit Eval ,q n-stn S-11v1..,4 44„4A- "- IQSite Work or Drainage Proposed Approved By: Date;�/3/� ..S-:s 1 ' it- 0Backflow Prevention for high hazard: ;(dental,medical,animals,mortuary,hospital, (supportive housing) FIRE DEPARTMENT OfRoute 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 ❑ 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: r4- 'ublic Works has no sco e---PW Not Required Additional Notes;- /Z `i7 d ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: