2225 100TH ST SE 2023-08-01 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# DO) 70(Z -061 BUILDING PLANNING Intake OK by: ®M Date: g 1 ZC'/ZA Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ 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/ .• apize ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone iz-.1 Number of Stories ( Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction - Residential Use c Q . yr F— Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: I Fire Sprinklers: ❑Update Existing ❑New System IRINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes 'No Reason Sprinklers Required: "In Lieu"Fee:Type: Amou $ Fire Alarm: El Update Existing El New System EINot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr it: RCW 64.55 MF worksheet req'd for permit? ❑Yes a No ❑Everett School Dist ❑Mu • eo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes o Additional Notes: VALUATION CALCULATION: Total$ Approved By: �, Date: l'2,,Ic2,zA UBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments:� L ,P�(W Worksheet Needed if:6: .3�1f sF ac/d/#ori. , !a,►Sys Dev Eval ❑Traffic Mit Eval (Attic nth hiclvited Mite Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By: /�i tL — Date:©t®C1Z022 f��, do r�� ,/ (dental,medical,animals,mortuary,hospital, sySivs €v f€4, 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Foldeier ❑Submitted Previously ❑Deferred Additional Notes: 'Ii This Pe ,'tl is WITby S b£lli Works ® See ii��YY►► esgeefband associated attached items Fire Dept.Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 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 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope.---PW Not Required Additional Notes: , _/ 1_ ELECTRICAL MA Siorirn sy _" d£v�l�mfrlf -ae [v Additional Notes: gj,20, -00 it 62.54/sr z 1/6. 69 Approved By: Date: Approved By: 4 Date: Rim-120w ?-12.