1726 63RD ST SE 2023-06-23 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 6 2-1 0 F^ 66 g BUILDING PLANNING Intake OK by: (2-t- l Date: e(!/Z®11 Intake OK by: Assign To: • Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 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 Si--6 L0 ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone el- Number of Stories 2. Overlay/Agreement Basement IJNo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use ll the„ .A 5 Occupancy Group Proposed No.of Dwelling Units: — Occupancy Load ,,�� Total No.of Dwelling Units: 1 Fire Sprinklers: CI Update Existing ❑New System L�'Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes , No Reason Sprinklers Required: ,,--,,.,,�� "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System LYNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: ,, // Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes L3/No ❑Everett School Dist ❑Mukilteo School Dist Add'RCW 64.55 docs required prior to final? ❑Yes E No Additional Notes: VALUATION CALCULATION: Total$ 2_90,000 Approved By: Date: q.`Z :Zi PUBLIC WORKS Intake OK by: . Date: _ _ Additional Notes: fNVP r(U-T rov- Intake Comments: Ipw Worksheet Needed if: 5 ,'-L_ i\p -T7&rug ;❑Sys Dev Eval ❑Traffic Mit Eval IDSite Work or Drainage Proposed Approved By: 4,4, Date:[(I/ Idj/ZD2I ❑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 ❑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: ra 'ublic Works has no scope---PW Not Required Additional Notes: A LC— lMl ..A. „ ELECTRICAL / Additional Notes: C�(to u Approved By: Date: Approved By: Date: