10200 19TH AVE SE 2023-01-26 - Laserfiche WebLink

Intake & Approval Sheet . (FOR PERMIT STAFF ONLY) 0 PERMIT # T71 t � I-- C01 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size t4 ccv _!l.+2 Garage/Accessory Struct. Size — Number of Stories 3- Basement No ❑Yes , Fin / Unfin Type of Construction �(— Occupancy Group Occupancy Load Fire Sprinklers: 91 Update Existing El New System El Not Req'd Reason Sprinklers Required: Fire Alarm: Update Existing ❑New System ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? Oyes No Addl RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ Additional Notes: Approved By: Date: 35/41 AN FIRE DEPARTMENT Intake: (Needed for Townhomes, Alley load SFR, New Commercial) ❑ Route to Fire Drawer --- Fire Preliminary Review Notice ❑Sending Fire Notes to Project Team Date: (OK to Route to Other Departments) �y Fire Sprinklers: FstUpdate Existing ❑New System ❑ Not Req'd Fire Alarm: Update Existing ❑New System ❑ Not Req'd Chemical Sup: El Update Existing fNew System ❑ Not Req'd Additional Notes: Approved By: Date: — — I ELECTRICAL Additional Notes. - Approved By: Date: PLANNING Intake OK by: Date: Intake Comments: Assign To: Attach to Project No. � A 3 Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone —Z Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: � it: ❑Everett School Dist ukilteo School Dist Additional Notes: Approved By: Date: . PUBLIC WORKS Intake OK by: Date: •----------------------------------------- Intake Comments: ;PW Worksheet Needed if.- ❑Sys Dev Eva] ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, supportive housing) ; ----------------------------------------- E]Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is In a Separate Green Folder (ioin with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Required Additional Notes: [Approved By: Date: 3 1