2217 MCDOUGALL AVE 2023-11-01 - Laserfiche WebLink

Intake & Approval Sheet* (FOR PERMIT STAFF 041�9 PERMIT # ijy oT- 06o BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this.a "W" ermit Bldg/TI/Add em Siz Garage/Accessory Struct. Size A10 Number of Stories 2- Basement No ❑Yes , Fin / Unfin Type of Construction rXC Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System NNot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System ANot Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes E9 No Addl RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ V, 000 Oo Additional Notes: Approved B Date: . 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: PLANN��IIyN��G,, Intake OK bAssign To: Date: - 2-q- 20-2-1 Intake Comments: ❑ Attach to Project No. ❑ Xute to Historic Reviewer OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone — 2. Overlay/Agreement Nonresidential Use . Residential Use 5 Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: - �i��.�✓ PUBLIC WORKS Intake OK by: Date: Intake Comments: 'PW Worksheet Needed if: !0Sys Dev Eval OTraffic Mit Eval El Site Work or Drainage Proposed . 0Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, :supportive housing) F ❑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 ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this foiderfor permit Issuance) ❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: