12800 19TH AVE SE 2022-07-14 - Laserfiche WebLink

II 111/ Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 5 2 I o/ - 0 6.5 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 Blcgtfl/ ddn/Rem Size 2 Sd /S'F ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement El No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction A;Q Residential Use Occupancy Group `, Proposed No.of Dwelling Units: Occupancy Load,{{.,, Total No.of Dwelling Units: Fire Sprinklers: 63Update Existing Chew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: Update Existing El New System El 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: VALUATION CALCULATION: Total$ Approved By: Y.,, Date: GI.IA,IA LIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: PW Worksheet Needed if: = Sys Dev Eval ❑Traffic Mit Eval =DSite Work or Drainage Proposed Approved B \ �C� Date: /�/O//Zpz/ _OBackflow 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 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 ❑ 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: