3004 17TH ST 2023-06-23 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# 13220(0 - b 30 //�� BUILDING PLANNING Intake OK by: 1� Date: 7-17-112_ 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 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories I Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Constructions Residential Use Occupancy Group 7.9—C. Proposed No.of Dwelling Units: Occupancy Load ..e—L Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System.PZNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Jo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑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 ''ENo ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yeslo Additional Notes: AD VALUATION CALCULATION: Total $ (;/6 0 C I / Approved By: I yr4146,4Date: L.2��7j'Z UBLIC WORKS Intake OK by: Date: Additional Notes: / Intake Comments: 1PW Worksheet Needed if: S(peu 1 1 �SPeGke - j❑Sys Dev Eval ❑Traffic Mit Eval t 44,424 ❑Site Work or Drainage Proposed Approved By: �' 1 Date: �frie z ❑Backflow 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) El Fire Sprinklers OFire Alarm El Other: AND ❑Create Green Folder ❑Submitted Previously ODeferred Additional Notes: ❑ This Permit is Approved by Public Works 0 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/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: