5700 23RD DR W 2022-12-30 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#ce--)22©q ^ 0 4- BUILDING PLANNING Intake OK by: Date: Intake OK brOVVV, Assign To: Date: Ll /1/2 2- Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a "W"Permit 0 OK to Route to Other Departments Bldddn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone L i 'Z Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use j(iml /C4v)r(Ii Type of Construction V 8 Residential Use Occupancy Group 4-3 Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers; TJpdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: COUpdate 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 1E1 No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 1.No Additional Notes: VALUATION CALCULATION: Total $/D DOO o(> i4A1 OPQ War54 /I /2Z- Approved By: Date: PUBLIC WORKS;; Intake OK by: I Date: Additional Notes:ZZ--C/#E. -1'1r, 4v /Zc 'l ti. Intake Comments: PW Worksheet Needed if: -� 56 5r: S+rD:- go-v- I❑Sys Dev Eval ❑Traffic Mit Eval 1 C—O ob.)%`�'� '-R- T ❑Site Work or Drainage Proposed 1-'�"A�'"'ts. S O I❑Backflow Prevention for high hazard: Approved B \ Date: D tLi•„ r/�.n (dental,medical,animals,mortuary,hospital, • 1supportive 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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ,Additional Notes: /v., i 0 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(join with this folder for permit issuance) ❑ Review/In ection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved BQ _y1/ Date: (-/-<3/4/17.e`L 0 Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved B V411)• Al: Date:4A Approved By: Date: