5109 W HIGHLAND RD 2023-04-24 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#C6 Z2—C)2-+a.9 BUILDING. PANNING t . Intake OK by:42_.Y-- Date: 311/2)0 2 Intake OK binlEad_ Assign To: Date: 2/,tg1Z7 Intake Comments: Intake Comments: k)•11?)*(1‘D (-eC 3.1-Zz mod. Zvi ('--OnNe-e412.115 ref ❑ 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/ em'Si e 11 (0j-- ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone IL-,I Number of Stories Overlay/Agreement Basement ❑No ®Yes 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 N,No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount Fire Alarm: ❑Update Existing ❑New System INot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: r Calculated: Cr it: RCW 64.55 MF worksheet req'd for permit? ❑Yes LJ No DEverett School Dist ❑Mu eo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: .} ci. F t\`U ".f," VALUATION CALCULATION: Total $ if�CJi Approved By: l( Date: .7/1 , ZZ PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: iPW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: v_-V Date: 313/ ZC,Z2 I❑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) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ 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/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: