921 105TH PL SE 2022-10-14 - Laserfiche WebLink

• Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 2Zb I -0 5 BUILDING PLANNING Intake OK by: .eAL Date: 2 U 22. Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑Attach to Project No. 14 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 ilk Zone e-\ Number of Stories Overlay/Agreement Basement ®No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use SW-- Occupancy Group Proposed No.of Dwelling Units: '— Occupancy Load TALC Total No.of Dwelling Units: Fire Sprinklers: El Update Existing El New System I \Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 122Clo Reason Sprinklers Required: "In Lieu"Fee:Type: A nt$ Fire Alarm: ❑Update Existing [hew System litNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: edit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ®,No ❑Everett School Dist ❑ ilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes &No Additional Notes: yvaz' c,�, ,_• VALUATION CALCULATION: Total$ 3 3 i Z4Co Approved By: )6,. Date: 9.'7fj; Z . BLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: _PW Worksheet Needed if: POSys Dev Eval ❑Traffic Mit Eval OSite Work or Drainage Proposed Approved By: ti F�� Date: u23f ZOZZ _(]Backflow Prevention for high hazard: i(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 ❑Submitted Previously ❑Deferred Additional Notes: ErThis Permit is Approved by Public Works KSee 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 ❑ 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: iaUkV fa root Approved By: Date: Approved By: AMM,/A 4mm Date: eJ j11 i1W,7/