1615 75TH ST SW PACE 2022-07-14 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) ,PERM T --i�- -d 6 BUILDING . . PLANNING" . Intake OK by: Date: Intake OK by Assign To: Date:2/I 1 tza- Intake Comments: Intake Comments: Q ❑ 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 L,ZQd Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . Q-r-6l.c!j 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 ONot 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 ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total - /YLQS:°4.2 1--)1 VI :ti ,12)- MM14,Si P2I i / 2- Approved By: Date: PUBLIC WORKS' Intake OK by: Date: Additional Notes: Intake Comments: ipw worksheet Needed if: bcs IOSys Dev Eval OTraffic'Mit Eval dqt i? ?�1027- IOSite Work or Drainage Proposed _ ;OBackflow Prevention for high hazard: Approved B.o-A� Date:o 1j,y 2,7 (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) El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: J ❑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 ❑ 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: