Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 132101 — 01-7 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size /JO ifF ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size /1/0 Zone <br /> Number of Stories / Overlay/Agreement <br /> Basement MNo DYes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use a 194 ) <br /> Occupancy Group It:I1-C— Proposed No.of Dwelling Units: <br /> Occupancy Load y Total No.of Dwelling Units: . 1ADO <br /> Fire Sprinklers: El Update Existing ONew System ®Not Req'd Planning/Landscape Inspection Required before Final? DYes arNo <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing El New System ElNot Req'd School Impact Fee: Total $ t I/' <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes ® No DEverett School Dist ❑Mukil School Dist <br /> Add'I RCW 64.55 docs required prior to final? DYes LINo Additional Notes: <br /> VALUATION CALCULATION: Total$ /.1`CO 06" ciNepesAi-\ {`, c_ „^ei C <br /> Approved By: .'"�JJ��J, Date: 11, <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> IDSys Dev Eval ❑Traffic Mit Eval <br /> IDSite Work or Drainage Proposed <br /> �� I OBackflow Prevention for high hazard: <br /> Approved By: ,f../ ° ` Date: /210 �'jh-z_f ;(dental,medical,animals,mortuary,hospital, <br /> ti / <br /> !supportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> OFire Sprinklers El Fire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public Works <br /> ca,See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 'z A Separate PW Permit is Required(Permit#: PW 2,1 - 0l! <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑1 Is located in this folder <br /> El Minimal or No Fire Scope-NO FIRE FEE I1s,1 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> 32-Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: :6 1(-O(,v.(\Date: JGi --- 2 ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: ..-7�1,�* �`� Date: /I <br />