10511 16TH PL W 2023-06-23 - Laserfiche WebLink

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY • PERMIT# V22°€'63 p f t BUILDING r PLANNING,/R Intake OK by: �` Date: 'II3jly Intake OK by:0' Assign To: 1�Jf . Date: 6/Nli 2Z Intake Comments: Intake Comments: ;ti0 ea 1- F-e•es ❑ Route to Commercial Building 0 Attach to Project No. c P at V; '(p 1 oute to Residential Building ElRoute to Historic Reviewer ❑ Make this a"W"Permit .12OK to Route to Other Departments Bldg/TI/Addlm Size ❑ Hold in Planning File Drawer Garage/Accessory Struct,Size Zone G" Number of Stories t Overlay/Agreement Basement allo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction SQ C.. Residential Use Occupancy Group tQ—C Proposed No.of Dwelling Units: Occupancy Load �� Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System Iflot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System cglivot Req'd School Impact Fee: Total $ • Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 1S No ❑Everett School Dist ❑Mukilteo School Dist Add'l RCW 64.55 does required prior to final? ❑Yes IRNo Additional Notes: VALUATION CALCULATION: Total$ Z©,,Oc1b Approved By: A Date: � (1 J 4 PUBLIC WORKS Intake OK by: 0 Date:.,._.,,,...,.,.,.,.,.,..,.,.._,.., ..,,w,.,..A.....-,...,.,.,,, Additional Notes: [� Intake Comments: EPW Worksheet Needed if: `DSys Dev Eval ❑Traffic Mit Eval t5 41 4 6 nb (,45\9,e) DSite Work or Drainage Proposed Approved By: Date: 416 frL I_IBackflow 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 I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) OFire 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 Qoin with this folder for permit issuance) 0 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: ELECTRICAL Additional Notes: Ylb S( t ..teY -P Approved By: Date: Approved By: Date: 3