2220 PINE ST 2022-01-20 - Laserfiche WebLink

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# C Z 00(ir ooS 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 I/ ddn/Rem Size ❑ Hold in Planning File-Drawer Garage/Accessory Struct. Size 414 Zone Number of Stories / Overlay/Agreement Basement 'LINO ❑Yes , Fin/Unfin Nonresidential Use Type of Construction v g Residential Use Occupancy Group /�-3 Proposed No.of Dwelling Units: Occupancy Load i3Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑ 11ry-1t New System �"Not Req'd PIarining/Laild�l.ape iiiF.,e tiorl Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$_ Fire Alarm: El Update Existing ❑New System 11.5,1Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ` No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes � o Additional Notes: VALUATION CALCULATION: Total$ S1vr�,d-7 Approved By& — Date: 7-Z PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: IOSys Dev Eval OTraffic Mit Eva! ❑Site Work or Drainage Proposed �,� ;OBackflow Prevention for high hazard: Approved B r,_.071: Date:07,Y LO Z, , (dental,medical,animals,mortuary,hospital, isupportive 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: ❑ 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 ,� El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: v-Public Works has no scope---PW Not R quired Additional Notes. ®7bbo l2.0 so ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: ‘-'7,