12906 19TH AVE SE 2023-04-07 - Laserfiche WebLink

411° Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# Q1 . BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: 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 ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size �jf Zone ^- Number of Stories /, Overlay/Agreement Basement ? No ❑Yes , Fin/Unfin Nonresidential Use {'ex_cLz. Type of Construction ti/i' Residential Use Occupancy Group /'Yi 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 ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Am Fire Alarm: ,Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: redit: RCW 64.55 MF worksheet req'd for permit? Oyes ❑ No ❑Everett School Dist ❑ kilteo School Dist Add!RCW 64.55 docs required prior to final?% ❑Yes ❑No Additional Notes: p� VALUATION CALCULATION: Total$(on° v Approved Date: S VA.12._CytO CC PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: =PW Worksheet Needed if: (]Sys Dev Eval ❑Traffic Mit Eval l❑Site Work or Drainage Proposed Approved By Date: c//� � OBackflow 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) W.Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:KPIczpuin Date:4/_14/...-20:,20 lic Works has no scope---PW Not Required Additional Notes: dg fb? /Zc ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: