9 77TH PL SW 2023-04-07 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# - 2 a -o(AS BUILDING 0 PLANNING , Intake OK by: Date: Intake OK by:U" Assign To: ffLL ,L Date: /1 2.9?-45 Intake Comments: Intake Comments: .......s Litirritrwrainwou..;i.. ❑ Route to Commercial Building Attach to Project No. v 1 2-0 Uaf f ❑ Route to Residential Building Route to Historic Reviewer ❑ Make this a"W" Permit )OK to Route to Other Departments Bldg/TI/Addn/Rem Size qv. 440- ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size — Zone V I Number of Stories Z Overlay/Agreement Basement IZINo ❑Yes, Fin/Unfin Nonresidential Use — 1 Type of Construction V- ' Residential Use U Occupancy Group Proposed No. of Dwelling Units: i Occupancy Load Total No.of Dwelling Units: 2 Fire Sprinklers: ❑Update Existing ❑New System 21Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: CI Update Existing ❑New System 120Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes IZINo Additional Notes: VALUATION CALCULATION: Total$ /i; J k Lo to!a( x i 2 t = IS0,Sew g co X B d= ,2. Approved By:oC Date: J 2,62A PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: I PW Worksheet Needed if: I i❑Sys Dev Eval OTraffic Mit Eval I Mite Work or Drainage Proposed Approved By: f ' Date: Z 1 �2 1 !❑Backflow Prevention for high hazard: f(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 i See PW Review Worksheet and associated attached items Fire Dept. Fees: * A Separate PW Permit is Required (Permit#: PW 20(0 -0 I-I ) ❑ 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:110?2wn Date: ,/-3;24,240 ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: /‘..\ Date: (O rg/ ..o