5222 EAST DR 2023-06-16 - Laserfiche WebLink

Intake &Approval Sheet I(FOR PERMIT STAFF ONLY) • PERMIT# (3Zl0g"b 51-4 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 0 Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments BldglTl/Addn/Rem Size 7Od off 0 Hold in Planning File Drawer Garage/Accessory Struct.Size y, Zone Number of Stories Overlay/Agreement Basement ,121No ss, Fin/Unfin Nonresidential Use . Type of Construction Residential Use ( , 41 /AfW Occupancy Group z L - Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: DUpdate Existing Chew System Mot Req'd Planning/Landscape Inspection Required before Final? ❑Yes jENo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing New System Z Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? DYes No ❑Everett School Dist ❑Mukilteo School Dist ' Add'I RCW 64.55 docs required prior to final? ❑Yes ,�No Additional Notes: *awl „JVALUATION CALCULATION: Total$ Z�049-O �,'"`� wwJ Approved By: Date: '. 7,Lit P LIC WORKS" Intake OK by: Date: Additional Notes: Intake Comments: jPW Worksheet Needed if: eat '/QC1 14Pr r0 �/1�fr0 � fi'�",4�,4s 1DSys Dev Eval ❑Traffic Mit Eval FL.O02 ,0L4 i/•FO/L A / dill S/O C/&GKLL'sl-, IDSite Work or Drainage Proposed Approved By' Date:///ze ;i]Backflow 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 OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: El 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 0 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: K,12j.,-p,A,n Date: 7"7 2/ ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: