510 HOME PL 2022-07-26 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# G 16t(*'OW BUILDING PLANNING Intake OK by: Date: S AS/t 7 Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building ❑Attach to Project No. E.Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn9 Size 237 50 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone a A Number of Stories Overlay/Agreement Basement ❑No DYes, Fin/Unfin Nonresidential Use Type of Construction Residential Use 144644 S — Occupancy Group Proposed No. of Dwelling Units: — Occupancy Load Total No.of Dwelling Units: 1... Fire Sprinklers: DUpdate Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Mlo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ J Fire Alarm: DUpdate Existing ❑New System ONot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credi • RCW 64.55 MF worksheet req'd for permit? DYes 0 No DEverett School Dist ❑Mukilt School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: In d ,-er i - no ,eleitor— VALUATION CALCULATION: Total$ 16,8 Z7 ( ( ./Q,,,o 0.4 (t it,:, .del")Approved By: IL. 1 Date: q.7,%Y) 1 PUBLIC WORKS Intake OK by: /, Date: g 201 Additional Notes: Z a i l f_C If 1456C_ Intake Comments:/yam PW Workshee Needed if: / & �� ( k I /N�' ❑Sys Dev Eval ❑Traffic Mit Eval / /�,L ❑Site Work or Drainage Proposed Approved By: Date: a(2 4p W, j'W DBackflow Prevention for high hazard: / (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute 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 OSubmitted 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 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 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: 3/�gl�ev°l z4