4202 S 3RD AVE 2022-07-13 - Laserfiche WebLink

411/ Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S V 0(2— 0(e 4 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 /23— 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: ❑Update Existing ❑New 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'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: [all L\on AID ,4 c VALUATION CALCULATION: Total$! ' LS.00 .W- Va- (v..i)fed , /, A" Approved By: 1L, Date: PUBLIC WORKS Intake OK by: . Date: PW Work.,,.,...,...:.............�_..__.:.:...,,..,,,..,.,.:.:.......,,._,.........,,, Additional Notes: Intake Comments: E sheet Needed if: iDSys Dev Eval OTraffic Mit Eval _OSite Work or Drainage Proposed Approved Datep/ / 7� =DBackflow Prevention for high hazard: 71 , _(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 OSubmitted Previously ❑Deferred Additional Notes: ❑This 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 ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: