10326 19TH PL W 2022-01-21 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#e 0 0Jr' l--) BUILDING PLANNING Intake OK by: Date: 511 I'M Intake OK by: Date: Intake Comments: Intake Comments: Assign To: \\'n\\et .?2,e,f4:\ i o. ("WCO` Y O Route to Commercial Building ❑ Attach to Project No. El Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg,TI/ ddn/ em Size 276 c.C.r. 0 Hold in Planning File Drawer Garage/Accessory Struct.Size eer- Zone - 2 Number of Stories / Overlay/Agreement Basement RiNo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction V E Residential Use S Occupancy Group Z. Proposed No.of Dwelling Units: Occupancy Load Total No. of Dwelling Units: CrN_ Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: - "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing Chew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 14 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes giNo Additional Notes: VALUATION CALCULATION: Total$ 2.401 /f8 274e73 Approved By: (---) Date: . \ 2jS\C\ PUBLIC WORKS Intake OK by T 1 Date: 3/ 14 i Zo 19 Additional Notes: 2.0( i'dC /,t)S- C.. Intake Comments: PW Worksheet Needed if: C-bNVC-0-4 1.14 S . GA 12.. ❑Sys Dev Eval ❑Traffic Mit Eval ►+.►'tc 1--'u.�►ta► Se VE ❑Site Work or Drainage Proposed Approved By: Date: 7////19 ,moo s i:F 1.. ❑Backflow Prevention for high hazard: pp -- o� (dental,medical,animals,mortuary,hospital, C 4.4tftra- t 4 Foo T'Pet'R4"< supportive housing) FIRE DEPARTMENTute 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 El Deferred Additional Notes: ❑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 ❑ 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: ,14 4 Date: OSybil 4 1 11 /�