8411 E XAVIER WAY 2023-10-16 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) 411PERMIT# BUILDING PLANNING ' / Intake OK by: i- Date:_ 3/212.0 Intake OK by:* Assign Tof u J�Q Date3/242 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 -ize 2rJ S 2 Hold in Planning File Drawer Garag- ° Gesso Struct.Size 71,q, .S. Zone Y"--- I Number of Stories 2 Overlay/Agreement Basement ❑No INIYes,e Unfin Nonresidential Use Type of Construction Residential Use -F12- Occupancy Group 2 7u Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: I Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before ` I? . ❑Yes No Reason Sprinklers Required: "In Lie ee:Type: mount$ Fire Alarm: DUpdate Existing ❑New System ONot Req'd School Impact Fe . otal $ Reason Fire Alarm Required: Calculated: redit: RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett Sch ist 0 Mukilteo Schoo Q� Add'I RCW 64.55 docs required prior to final? DYes ®No Additi Notes:Sew' '�Y i �� 19 v i'CeC VALUATION CALCULATION: Total$ I1(.i 006 676 -E616 a 73 lo0 @ too Approved By: Date: 152- a 25 PUBLIC WORKS I t Intake OK by: T 4 Date: 3/Z /Zo'a Additional Notes: 2,0!S I AC- +-WSV-c-. Intake Comments: i PW Worksheet eeded if.i4 41) ;CASyS v v I y OTraffic MitEVal �..4Cc-GA SAE.: - r pp s f I❑Site Work or Drainage Proposed 4.0u Approved By: 41 Date:3h6/ZO " T`'.l f G- `~ G"` OBackflow Prevention for high hazard: o Lfcqy"I4 S?A4.£ :(dental,medical,animals,mortuary,hospital, _ 00:1 Ryv-TCS :.. ga-vca :supportive housing) 'l'£az-...mac €-- -.-..........................._...._.. ............................._......-..._._........................... FIRE DEPARTMENT oute 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 OSubmitted Previously ❑Deferred Additional Notes: ; CI This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept.Fees: 0 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 Not- : i a `,Q. 1 ELECTRICAL sperc__Ilutr-- ' i Additional Notes: ttftk11'fA & f 4- SO iirtpitAkq I'E44jt). , nrofcec Approved By: Date: Approved By: j •--_` Date: the/zøw LitY i