2001 HOYT AVE B 2022-02-22 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) ' PERMIT# 0-1c‘OCo -00 4.- DING �i'" PLANNING rr Intake OK by: Date: tO r \ O— `9 Intake OK by: i/ Date: /O 1 Intake Comments. 1 a ! Intake Comments: )j Assign To: cite.. /� .2 t e 16AIOf iY ;/ I ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit F4I OK to Route to Other Departments g ` I/Addn/Rem Size Sp- s./ . ❑ Hold in Planning File Drawer .arage ccessory'Struct. Size 4 l O $K Zone -' Number of Stories Z Overlay/Agreement ram, ` `d. -n t Basement cZlNo ❑Yes, Fin/Unfin Nonresidential Use — Type of Construction S' Residential Use Sip Occupancy Group Q/a Proposed No. of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Fi Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Am t$ Fire Alarm: El Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: redit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: al VALUATION CALCULATION: Total$ I I bi IROGfl'I P' rnSPPCr�G� r V�V e 5©a @ It! l 0 48 Approved By:� Dater/2 /(4r PUBLIC WORKS Intake OK by:Y t% Date: (o 11 o 12.0 I Q Additional Notes: Z(9 I & /RC IIAJ.f1� Intake Comments: PWWorksheet Needed if: A4C-- -1 Frgct-AGt� Ar+-V ❑Sys Dev Eval ❑Traffic Mit Eval etia 6 -4641/r / 9 Pt 1/4.) Kite Work or Drainage Proposed Approved By: "� Date: �/g//g "p out SRowt S -r�, ❑Backflow Prevention for high hazard: w (dental,medical,animals,mortuary,hospital, MI S7( ��ors ' supportive housing) ff+00(oil ,h1£W laRiA SJc>bfAcor... FIRE DEPARTMENT El '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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 'A This Permit is Approved by Public Works vltit ye,e ;N AJ 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: u 0 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 :y:; _ Date: ?JZv1'/t? aia