11921 SILVER LAKE DR 2022-04-05 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# e_ 7cios -cog BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: EN'C \�l.3 Off©,fir.\.k Cs,�tsc Xc seok ❑ Route to Commercial Building 0 Attach to Project No. Jv �V b — VV ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size Q-4-4"15 4-4} 0 Hold in Planning File Drawer Garage/Accessory Struct, Size S Zone — Number of Stories Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System aINot Req'd Planning/Landscape Inspection Required re Final? ❑Yes InNo 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 ® No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ZiNo Additional Notes: VALUATION CALCULATION: Total$ I qG S&4 I OS-is So = Sze 40t.6E7 BSo x 12_1 1 OCP J -F av Approved Date: a ,� x 30 \\.Q)3.Zc)2o R23 • +5 io/�}4 PUBLIC WORKS 532_,r ' 1 3d 3°0 Intake OK by: Date: Additional Notes: Intake Comments: 1PW Worksheet Needed if: I❑Sys Dev Eval ❑Traffic Mit Eval I❑Site Work or Drainage Proposed Approved By: $•• Date: 11'JQ5 '❑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: This Permit is Approved by Public Works 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 ❑ 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 0 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 By: Date: '%ll v pP PP � l 2�