2616 HARRISON AVE 2022-06-28 - Laserfiche WebLink

Intake &Approval Sheet 1110 (FOR PERMIT STAFF ONLY) • PERMIT# 12S c-co . 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 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Constructionf Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System Ir3Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System 5Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: ❑ rr✓� RCW 64.55 MF worksheet req'd for permit? Yes I L No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ®No Additional Notes: VALUATION CALCULATION: Total$ ,SOO Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: 2,0 j 5 //L C Intake Comments: _PW Worksheet Needed if: f-/44.b //I fP 6C.T(oM =❑Sys Dev Eval ❑Traffic Mit Eval I❑Site Work or Drainage Proposed Approved By: Date: 3/6/Z(3 I❑Backflow Prevention for high hazard: (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 .t, Additional Notes: 0 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 0 Is located in this folder O Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder Gain with this folder for permit issuance) O Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: