1019 PACIFIC AVE 2023-04-07 - Laserfiche WebLink

• 527-02-- (10(0 Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# BUILDING PLANNING Intake OK by: Date: Intake OK Assign To: Date:2[/ aq /2Z_ Intake Comments: Intake Comments: ❑ 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/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone U1Z- Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El 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: ❑Update Existing ONew 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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add]RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ ' \� / p� (Y1Cur- e ��/�Z j/m A.! li Approved By: Date: PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: PW Worksheet Needed if: i❑Sys Dev Eval OTraffic Mit Eval i❑Site Work or Drainage Proposed ❑�,I Backflow Prevention for high hazard: Approved By: ✓ Date: 9...c Bey./ — (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 El 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: