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

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) 1110 PERMIT# 2oI— I 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/Tl/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 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 ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing Chew 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 ❑Everett School Dist ❑Mukilteo School Dist Add'l RCW 64,55 dots required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: lPWWorksheet Needed if =OSys Dev Eval OTraffic Mit Eval =DSite Work or Drainage Proposed Approved By: Date: IOBackflow Prevention for high hazard: • 1(dental,medical,animals,mortuary,hospital, !supportive housing) • FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate I 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: LAThis 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 0 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: �� n ' Date: ) _25, ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL 0przl✓' Valle L?� Additional Notes: Approved By: Date: Approved By74b'7 � 1 Date: O//74 /20 22 • 2/