3025 LOMBARD AVE 2023-05-23 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# S9.2 605 BUILDING PLANNING` Intake OK by: Date: Intake OK by: Assign To: JJ Date:0813142- Intake Comments: Intake Comm ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit JZ OK to Route to Other Departments Bldg/Tl/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone P tw.ed k rbc n, MtU Number of Stories Overlay/Agreement Me+ro 1=vere#r Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Corr►m 'r vj c.enk-e' Type of Construction Residential Use NIA Occupancy Group Proposed No.of Dwelling Units: �t/A Occupancy Load Total No.of Dwelling Units: N/A Fire Sprinklers: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes EINo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: CI Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Evereft School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes:P tan 523r in a i co.#'es IA)r0" 1•0 e &Si9n VALUATION CALCULATION: Total$ 21 37, 7g Ca1•egorv\, 130- Proposed Stayn(5) are, no4 more. / iinOon max. scZe oh applicabte Sky) e43.4re5or • Approved By: u,z� r Date: OS/31 122 PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval =DSite Work or Drainage Proposed Approved Date:0 0007 ❑B8CkflOW Prevention for high hazard: i(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: 0 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(loin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 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: Ii