9103 5TH PL W A & B 2023-07-28 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# Z t 1.2 -0/b BUILDING . , PLANNING • • . • Intake OK by: Date: Intake OK by: Assign To: Date: 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/Add em Sjz Z,gyl ,5l 0 Hold in Planning File Drawer Garage/Accessory Struct.Size 9 `/ is"P Zone Number of Stories / Overlay/Agreement Basement ' No ❑Yes, Fin/Unfin Nonresidential Use . Type of Construction • 2/LL Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load /d • • Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System PINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El 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 No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes iSqNo Additional Notes: l- VALUATION CALCULATION: Total$ 2-45‘.5;060.6 406sin/1 l fa -dozed t n levA Approved By: WW1 IA-NO Date: 12.4 tep I�LA PUBLIC WORKS:` Intake OK by: Date: Additional Notes: Intake Comments: 1PW Worksheet Needed if: =DSys Dev Eval ❑Traffic'Mit Eval • ❑Site Work or Drainage Proposed. Approved By; Jh Date: 7 'z��1 ;OBackflow Prevention for high hazard: / ' _(dental,medical,animals,mortuary,hospital, (supportive housing) FIRE DEPARTMENT El 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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El 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: ELECTRICAL Additional Notes: 4 Approved By: Date: Approved By: Date: MI O2.1