1015 PINE ST 2022-02-15 - Laserfiche WebLink

• Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# 2-°D t -o t° BUILDING PLANNING , Intake OK by: Date: I/slap Intake OK bycI Assign To: `cAC� f: Date: VOJ 3.2 e Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. Er Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit Q OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/ ccesso Struct. Size Z j 1O 2 4 Zone K_ Number of Stories 1 (2vw& F40o() Overlay/Agreement Basement IANo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction ',g Residential Use SM Occupancy Group ( Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: ©fie. Fire Sprinklers: El 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 El New System ONot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cre ' : RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett School Dist El mu . eo School Dist Addi RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: VALUATION CALCULATION: Total$ 6go© �'taP& o(t Wo ILK �Pr`b; 4 I J' - — Approved By:�� I Date: A,Oq_'LpZ� PZ&1�tGV6 t�rrcWt>1� Nog`C3 PRI+ItG, t,I.�c.L. A b 0 2 ghfsw wlNtaov-bc, I-0902 GG''tt PUBLIC WORKS PK-L—W I tv so to f I £LIPWG 4C.4c Door. Intake OK by: )!-C-r,'".3" Date: 1k 7,o Additional Notes: Z.49/S- <4e_ Intake Comments: 1 �� PW Worksheet Needed if: Iwt- ` '� ' 't c. '❑Sys Dev Eval OTraffic Mit Eval I❑Site Work or Drainage Proposed Approved By: C 1, .i Date: 2,/3620 I❑Backflow Prevention for high hazard: �' �� I(dental,medical,animals,mortuary,hospital, 'supportive 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) ❑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 0 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: gt Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: ll Approved By: Date: Approved By: ,i< � Date: \ \Alp