2128 PINE ST 2022-01-20 - Laserfiche WebLink

Intake &Approval Sheet 1110 (FOR PERMIT STAFF ONLI9 4111 PERMIT# OV�l 08�O BUILDING PLANNING Intake OK by: Date: b/227fL' Intake OK by: Date: Intake Comments. Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. );21Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn el ize 1 (a. 0 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 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? ❑Yes EINo 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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$_ 8 Z36 /(6 ca 7i /s. . Approved By Date: `' 0 20`c PUBLIC WORKS Intake OK by:'1— Date: , 2-3 /20 14 Additional Notes: ZO/i$ /ittL. # 144S6C. Intake Comments: PW Worksheet Needed if: t Z", w60-e— ❑Sys Dev Eval ❑Traffic Mit Eval �wkt.-'< ❑Site Work or Drainage Proposed Approved By: Date: /0%067. ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT oute 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: 0 This Permit is Approved by Public Works 0 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 0 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: I► Public Works has no scope---PW Not quired Additional Notes: ELECTRICAL eft 1 �/ Additional Notes: Approved By: Date: Approved By: Date: