119 W INTERCITY AVE 2022-07-26 - Laserfiche WebLink

Intake &Approval Sheet I (FOR PERMIT STAFF ONLY) • PERMIT# iiVU\," 6 E0--DU-' BUILDING PLANNING ` Intake OK by: Date: Intake OK by: W\' Assign To: V-10,Ir-p Date: 10.2 /• I y Intake Comments: Intake Comments: Latra v ( d\ . zy. )f ❑ Route to Commercial Building ttach to Project No. T'Yt 't€v RCJJ1‘16I,--o% ❑ Route to Residential Building LJ 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 c_-1 Number of Stories _ Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use aArAor,a 'f'(L Occupancy Group Proposed No.of Dwelling Units: -- Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? 1'es ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amou $ Fire Alarm: ❑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? DYes 0 No ❑Everett School Dist ❑Mukilteo chool Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: 7,e)-- 7,0 PUBLIC WORKS Intake OK by:fl- Date: I 12 4-I Zo 1 ' Additional Notes: Intake Comments: I PW Worksheet Needed if: �►o R.10 vFfrt-c- IDSys Dev Eval ❑Traffic Mit Eval 4{S%ottJc ao,.► DSite Work or Drainage Proposed Approved By: Date: �'�.{ -pF�z,u�.. 4Pa it.- =�Backflow Prevention for high hazard: ((dental,medical,animals,mortuary,hospital, LA1.ivS0-w?..iCw. (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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ; is Permit is Approved by Public Works 0 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 Date: 45..712 Z 7z. 2,o