2415 11TH ST 2022-07-21 - Laserfiche WebLink

• Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# (3?/ 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 Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El 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 ❑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 DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: ,� VALUATION CALCULATION: Total$ Z4, /'n n �If� 2��/r`�-�'t v" Approved By:X� i4- Date: PUBLIC WORKS Intake OK by: . Date: Additional Notes: '1�tzCnE�t dN,�t , Tt k 10 Intake Comments: =PW Worksheet Needed if. Ea 'T 2" r—ai I+XPU 9 . _OSys Dev Eval OTraffic Mit Eval OSite Work or Drainage Proposed e� Date: 9;0(a.G21 _�Backflow Prevention for high hazard: Approved By: I • :(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT I ❑Route this folder for'PW Review at end -:PIN Review Worksheet WYw Separate/Deferred Submittals Required: OThis project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: 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: ❑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 ❑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: