1706 112TH ST SE 2023-10-26 - Laserfiche WebLink

Intake & Approval Sheet 0(FOR PERMIT STAFF ONLY • PERMIT # O21°`g—fl,30Z BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make thi it Bldg/TI/Add Size Garage/Accessory Struct. Size IVO Number of Stories Basement NINo ❑Yes , Fin ! Unfin Type of Construction Occupancy Group Occupancy Load s Fire Sprinklers: ❑Update Existing ❑New System 5Not Req'd Reason Sprinklers Required: Fire Alarm: ❑ Update Existing ❑ New System ONot Req'd Reason Fire Alarm Required: IV RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add1 RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ i Additional Notes: Approved g*•K Dater FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach toProjectNo. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use . Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ONO "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukiiteo School Dist Additional Notes: JApproved By: Date: PUBLIC W6kKS' Intake OK by: Date: ........... .... .,..... _............................... ..... _...... _........................ ........ ..................... ....................... Intake Comments: J'PWWorksheet Needed if.• USys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: ;(dental, medical, animals, mortuary, hospital, :supportive housing) :...................._.....,....... .... ... ,....,..,...,.........._... .................. ,,..,............ ... ......._............. ❑Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred This Permit is Approved by Public Works ' See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) d in this folder ANDgas eparate Green Folder Gain with this folderforpermit Issuance) ssued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ P no scope --- PW Not Required Add' onal Notes: ,� �t/► ,/ �� M W(/'� 1 l( OtM Approved By: I/UL Date: 01 u