416 VERALENE WAY SW 2023-04-11 - Laserfiche WebLink

n LJ Intake & Approval Sheet (FOR PERMIT STAFF ONLY) * PERMIT # 6 2 10 -- 0 33 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a' "Permit Bldg/TI/Add em Si 700 f Garage/Accessory Struct. Size S Number of Stories % Basement ❑No 13Yes Fi / Unfin Type of Construction Occupancy Group ,QC Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System PN,t 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? ❑Yes IN No Add'[ RCW 64.55 docs required prior to final? ❑Yes I�No VALUATION CALCULATION: Total $ 6ddazoo Additional Notes: Approved B : Date: e /� 1p FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: �- Total No. of Dwelling Units: Q� PlanninglLandscape Inspection Required before Final? ❑Yes ANo "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Cr ❑Everett School Dist ❑_NleIlteo School Dist Additional Notes: Approved Date: PUBLIC WORKS Intake OK by:. Date: ,_....-.,.._.... ................. ........ __..... ,-.. Intake Comments: _PWWorksheet Needed if.• ❑Sys Dev Eva] ❑Traffic Mit Eva] E]Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, =supportive housing) �..,... ,..� ,.,m.,.,... ,.� .,a....., ......... ........... .,., . ,.,. _ ... ❑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 Coin with this folderfor permit issuance) ❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: