11014 19TH AVE SE LOMI LOMI SPA 2022-05-06

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# B2-\ 0 3 - 043 BUILDING PLANNING� Intake OK by: Date: Intake OK by: Assign To:-A{(2) .rj. Date: Si V/ Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments BI g I/A do/Rem Size 'fOO ,,5 Hold in Planning File Drawer Garage/Accessory Struct.Size ,i///o Zone 1M V Number of Stories / Overlay/Agreement Basement ' No ❑Yes, Fin/Unfin Nonresidential Use mOcgal&eats lar Type of Construction Residential Use Occupancy Group /' /,QQ Proposed No.of Dwelling Units: Occupancy Load 23 Total No.of Dwelling Units: Fire Sprinklers:, upaate leg ❑New System rthot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Reason Sprinklers Required: „g'Ideo O3/67 _ Z� "In Lieu"Fee: Type: Amount$ Fire Alarm: ist g ❑New System l Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes a No ❑Everett School Dist ❑Mukilteo School Dist Add'i RCW 64.55 docs required prior to final? ❑Yes EINo Additional Notes: VALUATION CALCULATION: Total$4 ,raa.aO Approved By: AS, Date: 4,2,5..2 L4 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval Mite Work or Drainage Proposed Approved By' Date:Dy/c�8�0p�/ ❑Backflow Prevention for high hazard: / (dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT DRoute 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) CI Fire Sprinklers ['Fire Alarm ❑Other: AND OCreate 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: 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 El 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: ,Brocti n Date:06 L2/ ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: ��Z