5221 23RD AVE W 2023-04-10 - Laserfiche WebLink

w • , Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 15°P-t Ory `ak 41 BUILDING PLANNING Intake OK by: Date: Intake OK by:a6 Assign To:PRQK e.. Date: 47.I+2024 Intake Comments: Intake Comments: 0eo otSes.srvierrf JGi-er7 Siteaart leo.ywarotalsa sea east raper i. El Route to Commercial Building El Attach to Project No. Pry ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size 2l3S T 1'- ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone 12,-S Number of Stories .,1�{�.,.,. Overlay/Agreement Basement Ia1No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction mC Residential Use S F j- Occupancy Group MG. Proposed No.of Dwelling Units: Occupancy Load lZ G Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System INNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System giNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes Gil No ❑Everett School Dist ❑Mukilteo School Dist Add'l RCW 64.55 docs required prior to final? ❑Yes Milo Additional Notes: VALUATION CALCULATION: Total$ (.onJ boo Approved By: 645 Date:Jo I i/2'2-1 PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: :PW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By: E7 Date: �I ��.Zt _(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT El 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AN ❑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 Qoin 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 kri-A-ckD ,()Y i��ELECTRICA L ,1",�rO t'`� Additional Notes: V V Approved By: Date: Approved By: Date: 7/ 9