4924 DOGWOOD DR 2022-06-27 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) S PERMIT# CA41 ,q0o coo. BUILDING PLANNING Intake OK by: Date: ►©A/(q Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ET Route to Residential Building ❑ Route to Historic Reviewer Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn Z->I>L .ize /0 7 Z S,,f ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size :?/tro Zone g_ , Number of Stories I Overlay/Agreement Basement El No IgYes, in Unfin Nonresidential Use ��" Type of Construction ().Residential Use r U"4 �L-. Occupancy Group R-A4 Proposed No.of Dwelling Units: — Occupancy Load Total No.of Dwelling Units: '1- Fire Sprinklers: ❑Update Existing ❑New System CgrNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Jio Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing El New System Uallot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes IR No ❑Everett School Dist ❑Mukilteo School ist Add'I RCW 64.55 does required prior to final? ❑Yes No Additional Notes: 0 c t4`,, fcs/O e_ o cereed VALUATION CALCULATION: Total$ SW 6a / ()al)eon- cP 4,W, ,e,(Akk — Ivnie for t,Wl` `✓ Approved By: y_Avizi Date: i 0 .c )q PUBLIC WORKS Intake OK by: Date: Additional Notes: Z c l-S— / WS4EC Intake Comments: iPW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: G1 119/1g DBackflow 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) El Fire Sprinklers ❑Fire Alarm DOther: 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: 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 ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE I ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 'IL 'ublic Works has no scope---PW Not Required dditional Notes: ELECTRICAL Additional Notes: ^ lAkf/n+U ( it10)(16P/14) Yg Approved By: Date: Approved By: ��+"— -- Date: C )