1410 119TH PL SE 2022-07-19 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# T) $r BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size Gj cl ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size + Zone Number of Stories R Overlay/Agreement Basement No Oyes , Fin/U fin Nonresidential Use Type of Construction V-1 �J 5 Residential Use Ste'Z Occupancy Group Z Proposed No.of Dwelling Units: Occupancy Load 41 Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System 15iNot Req'd Planning/Landscape Inspection Requir-• •- ore Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System lot Req'd School Impact Fee: Tot. Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 01 No ❑Everett Scho. Dist ❑Mukilteo School Dist Addl RCW 64.55 docs required prior to final? Dyes lNo Additional Notes: VALUATION CALCULATION: Total$ Cs/AO x ill � '�7r 1 w - / 7 Approved Th� Dater,\`A., PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: /Add 1, it.d apr 10Sys Dev Eval OTraffic Mit Eval I❑Site Work or Drainage Proposed Approved By: �. .�/ y72,--- Date:47-0 oC/d ❑Backflow Prevention for high hazard: =:(dental,medical,animals,mortuary,hospital, isupportive 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: o' ❑ 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-y;• FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Sco./-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) El Review/Inspection, cope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date:7 :V Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Pk(' (`e,. f Approved By: Date: / Approved By: KAk Date: (0 /4 if„.0