3018 21ST ST 2023-06-22 - Laserfiche WebLink

• A1 Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# 22OZ —OL ? BUILDING � PLANNING Intake OK by: 1e ` Date: 2/22c/2 2-- Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑Attach to Project No. a Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size L13 0 ffi71- Zone —Z. Number of Stories 1 Overlay/Agreement Basement 31No DYes, Fin/Unfin Nonresidential Use Q.$s %A,O.L'c4.Ssc 1 VIAMPt(cri.) Type of Construction Residential Use Occupancy Group 3-1►2-- Proposed No.of Dwelling Units: Occupancy Load • Total No.of Dwelling Units: Q}I‘k Fire Sprinklers: El Update Existing ❑New System ElNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing ❑New System Not Req'd School Impact Fee: Total $ -r!� Reason Fire Alarm Required: Calculated: Credit:__.- RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett School Dist ❑1gu..kftteo School Dist Add!RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: VALUATION CALCULATION: Total$ 3 F 7 7 PT le LvcrtN'- Approved B Date: (p VA tO1, PUBLIC WORKS'" Intake OK by: Date: Additional Notes: Intake Comments: JPW Worksheet Needed if: 10Sys Dev Eval ❑Traffic Mit Eval • f Z3l 2 ❑Site Work or Drainage Proposed Approved By: 4v-r__ Date: ❑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 OCreate Green Folder OSubmitted Previously ❑Deferred Additional Notes: This Permit is Approved by Public Works l.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) ❑ 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 B L� Date: et-i se 12.2-z.._