9612 19TH AVE SE B 2023-12-18 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # �SZ-UO1 0 b 7 BUILDING Intake OK by: J", Date: /01?V2VZ-2_ Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size 43-7 ✓' 3 0- Garage/Accessory Struct. Size s�ol 9f' Number of Stories �J Basement igNo ❑Yes , Fin / Unfin Type of ConstructionL Occupancy Group Occupancy Load L Fire Sprinklers: ❑Update Existing WNew System ❑Not Req'd Reason Sprinklers Required: 9D&WHVftC— J004-A /3- Fire Alarm: ❑Update Existing ❑New System 9Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add'I RCW 64.55 docs required prior to final? ❑Yes EINo VALUATION CALCULATION: Total $ 2 51 i 10 1 (5-7 3 x 13L-D 5(01 xsl Additional Notes: Approved By: - Date:1013120 zZ FIRE DEPARTMENT Separate / Deferred Submittals Required: dFire 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 9 Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ) C)- ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ 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 ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ ,?y/a - Calculated: O Credit: ,2O/ REverett School Dist ❑Mukilteo School Dist Additional Notes: J- "j " Z 7- C/Y /Z/// / %) Z- �t �14 /,� `Z 3 Approved By: f�lc C Date: - Z_� PUBLIC WORKS Intake OK by: Date: 0Y - 22- 2i- - .......... ................. ................................... ....... .... _................................................ ......... ._.... _ .. Intake Comments: PW Worksheet Needed if. []Sys 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 06ubmitted Previously []Deferred This Permit is Approved by Public Works See PW Review Worksheet and associated attached items d A Separate PW Permit is Required (Permit #: PW AND ❑// Is located in this folder 62Y Is in a Separate Green Folder Qoin with this folder for 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: prr Date: