2815 21ST ST 2023-06-23 - Laserfiche WebLink

410 Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# O V ` --- ' BUILDING PLANNING Intake OK by: Date: Intake OK by: VT Assign To: pi / Date: I Z//51/1 Intake Comments: Intake Comments: , n \' OW} 'tt5 f� Y1�a�1 . Nen -fkiS G DA--4,-' re4W� vr(`Q-Va,vr S OM ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building El Route to Historic Reviewer El Make this a"W"Permit P.f0K to Route to Other Departments Bldg/TI/Add em ize 9445 O .SS 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone F--Z Number of Stories Z Overlay/Agreement _1\Je_( 1 -S"i C c G Basement IXNo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction 'y B Residential Use S OccupancyGroup e 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 4No Reason Sprinklers Required: "In i "Fee:Type: Amount$ Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fe . of Reason Fire Alarm Required: Calculated: edit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Eve chool Dist ❑Mukilteo Soho • t Add'l RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ S i OSO I c Approved a s'- i ate: 1411 S/ 2 9 PUBLIC WORKS /( Intake OK by: l Date: ... Additional Notes: ZO/S it G it 60S-1G Intake Comments: 1PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval i❑Site Work or Drainage Proposed Approved By:\1 '""w Date: 1 '))0\oo i❑Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, �fiv\ 1(A,Ins .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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 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 0 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 dditional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: