2815 19TH ST 2023-06-23 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# `"''' '°7 '06)? BUILDING PLANNING p.. Intake OK by: Qt'+ Date: 1(3!/_Z_1 Intake OK by: ,3 J Assign To: Date: (' /3( Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size, Zone Q -Z Number of Stories Overlay/Agreement none__ Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction s Residential Use Sc c- Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System 'Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 0-No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing ❑New System IZ1Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑ rvr Yes No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ra-No Additional Notes: S}'ems e. QV_l d 5e c t- ext epkt o>c VALUATION CALCULATION: Total $ V OIOC) cO,C' cror+1- ackc. red:,ckic —i Approved By: Date: S /31 f22 PUBLIC WORKS, Intake OK by: Date: Additional Notes: 5. 1 G `„ t� Intake Comments: PW Worksheet Needed if: I d_, _ Uid' -�J j❑Sys Dev Eval ❑Traffic Mit Eval .eP EIvv ❑Site Work or Drainage Proposed Approved By: �}.1 Date: 15131 '"'j,Z ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, Isupportive 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: ❑ 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(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: Date: -Public Works has no scope--- PW Not Required Additional Notes: '' �" ,n,^ '� JJ ,, ELECTRICAL �� WI pI ,�� vLU.. ` 0 Additional Notes: 11 0 e J Kai 31 I?,0 ZZ Approved By: Date: Approved By: Date: