12906 19TH AVE SE IN N OUT PHO 2023-06-13

EZ2O -005 Intake &Approval Sheet S (FOR PERMIT STAFF ONLY) • PERMIT#FI\ ZOGj- (rp BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 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 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 Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew 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: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed I❑Backflow Prevention for high hazard: Approved By: Date: 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) ['Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works 0 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 0 Is in a Separate Green Folder(join with this folder for permit issuance) E'Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) Approved By: 19•) jiAiy-\Date:,f—' - z ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: