2309 CALIFORNIA ST 2023-04-05 - Laserfiche WebLink

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) illPERMIT# -221)� -ems BUILDING PLANNING Intake OK by: K' Date: /Z/Ze)2-2_-- Intake OK byal71., Assign To: Date:7/22/_ Intake Comments: Intake Comments: t)1kVLA ❑ 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 E31dg/TI/Addn/Rem Size 522i) 5-F- ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Ji i'Li Number of Stories i Overlay/Agreement Basement gNo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction ( _ Residential Use Occupancy GroupV Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ID 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 ID New System ONot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ONo Additional Notes: VALUATION CALCULATION: Total $_.,6 )j wU 0 ,, 1 ..3�i, $ F x S2 5+ = 7 6-0O �v1 W. 1l' 2/ Approved By: Date: PUBLIC WORKS Intake OK by: '`� Date: ` Z� Additional Notes: Intake Comments: PW Worksheet Needed if: iliZiSys Dev Eval DTraffic Mit Eval USite Work or Drainage Proposed Approved By: izse., Date: 5j �i�/��}v��,� ❑Backflow Prevention for high hazard: l (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 ID Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted Previously ID Deferred Additional Notes: ® This Permit is Approved by Public Works 51 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW 21iD1 O(b ) ❑ Review of As-Built Plans- NO FIRE FEE AND al Is located in this folder I0 Minimal or No Fire Scope- NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) I0 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 B ? Date: ( pppp Y;;7�ifki/VWJI, U1l(24 , 172 ZZ'