2232 12TH ST 110 2022-10-10 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT#t7j22o2-OD k 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 ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement EINo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction If-A Residential Use I -\'C Occupancy Group R — e77Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing Chew System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee: Type: Amount 1T Fire Alarm: .Jpdate Existing El 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 El No ❑Everett School Dist Mukilteo School Dist Add!RCW 64.55 docs required prior to final? ❑Yes 12 No Additional Notes: VALUATION CALCULATION: Total $ 70)C761 - Approv y: �— Date: Z., PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPWWorksheetNeededif: I UG 0 10Sys Dev Eval ❑Traffic Mit Eval "Mite Work or Drainage Proposed Approved By: Date: /QZ//2A I❑Backflow Prevention for high hazard: (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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ 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-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder aoin 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: ; (d Date: 3 -�.„2 ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: