10025 9TH AVE W 2023-07-28 - Laserfiche WebLink

• '02 Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 2O55"O 2-- BUILDING PLANNING • Intake OK by: Date: 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 -' ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories -- Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group -' Proposed No.of Dwelling Units: Occupancy Load -- Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑YesAlo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing El New System YNNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? {Yes ❑ No DEverett School Dist ❑Mukilteo School Dist Add!RCW 64.55 docs required prior to final? ❑Yes '=11 No Additional Notes: �A �� VALUATION CALCULATION: Total$ �D/ 000 v .` r Lao— - o 6 &D 0,5 (zA Q` /, 'e (A)/ i f'dti"^rI'- Approved By: ' ,t Date: S• t4 Z2_ BLIC WORKS Intake OK by: . Date: Additional Notes: g' 4." Pq t� Intake Comments: PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval IOSite Work or Drainage Proposed Approved By: 7 Date: 5 JS i 20 i,?� (-1Backflow 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) ❑Fire Sprinklers ❑Fire Alarm El 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: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 21Z