1427 100TH ST SW CLUBHOUSE 2022-01-27

XX��rr��,(I,�-,- Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# 1i/2tDU"J 1)7 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Add em Siz 030 0 Hold in Planning File Drawer Garage/Accessory Struct..Size /✓O Zone Number of Stories Z Overlay/Agreement Basement ,No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction VS Residential Use Occupancy Group ,4 3 Proposed No.of Dwelling Units: Occupancy Load 2z/ Total No. of Dwelling Units: 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 ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes era No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes lNo Additional Notes: VALUATION CALCULATION: Total$3,85 6/O Olb Approved By ' Date: —7 r'. PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: 'PW Worksheet i -ededif: DSys Dev -val ❑Traffic Mit Eval OSite ,c ork or Drainage Proposed Approved B Date:p/�Z5� 'Z� 10 ckflow Prevention for high hazard: / -ntal,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute this folder for PW Rev at end ---PW Review Worksheet Separate/Deferred Submittals Required: DThis project also has a se'.rate concurrent PW Review(Green Folder) ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Fol:er ❑Submitted Previously ❑Deferred Additional Notes: ; ❑This Permit is Appr,. ed by Public Works 3 0 See PW Review I orksheet and associated attached items Fire Dept.Fees: ❑A Separate P 'I Permit is Required(Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is I. ated in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ I n a Separate Green Folder(loin with this folder for permit issuance) Review/Inspection Scope-ADD FIRE FEE ■ ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: ,Kfiown Date: 5` ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: