1430 112TH ST SE 2022-05-11 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# ) 0—0 I t BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To:_ Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone �. Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use At\ioV- Tarnl) nt14-,Q. Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes flo Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ Fire Alarm: ❑Update Existing New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? El Yes ❑ No DEverett School Dist �,,Q❑�MukilteoSch I Dist Add'I RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: fa,0"' e Ae\e..6 a^ c4a1b d r,< VALUATION CALCULATION: Total$ 0107 (ece'... awe_ kS b Approved By: ,[, , d Date: 16, 1• Z�`ZO PUBLIC WORKS Intake OK by: Date: Additional Notes: 14O04TT "iut 'c GtfC/L r7.49✓J Intake Comments: I PW Worksheet Needed if: SLC� "e./tirr 4fl94r 4rrcyv [❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed Approved By: _ _ _ Date: i❑Backflow Prevention for high hazard: _ I(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT 7' DRoute this folder for PW Review at end ---PW Review Worksheet Separate 1 Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) Et Fire Sprinklers ❑Fire Alarm ❑Other: ,. AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 1; ❑ This Permit is Approved by Public Works 1.c mace 4Y1 Co ckdr.,145 Ae. .Spfqr1 y ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: G1rc- �Vi ❑ A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑7I Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ,aReview/Inspection Scope-ADD FIRE FEE U I e issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By:<,r- w in Date: /J/. 0 , Public Work as no scope--- PW Not Required otes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 1 1