820 41ST PL 2022-10-07 - Laserfiche WebLink

�GAsi'$a -•-,-.or rso-c.P( Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 8 2 Z 3—04-4 a-- BUILDING / PLANNING 7/ Intake OK by: I`fL • Date: 11/20 2-2 Intake OK by: Assign To: DateTl/j(/21_ Intake Comments: Intake Comment ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load • Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System El 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!RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total$ TO(41-1('PA (Y) 7(J/ /2l Approved By: Date: PUBLIC WORKS. Intake OK by: Date: Additional Notes: Intake Comments: =PW Worksheet Needed if: 10Sys Dev Eval ❑Traffic Mit Eval • • =OSite Work or Drainage Proposed Approved By: /«k. Date: 7/ivy)22- ❑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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND OCreate Green Folder El Submitted Previously ❑Deferred • ❑This Permit is A roved byPublic Works • w • Additional Notes: ,� pp ❑ 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: