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

Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT # IU 7 6 t t` BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size /J f LiL( SIF Garage/Accessory Struct. Size 5 37 $ -F Number of Stories 3 Basement 1QNo ❑Yes , Fin / Unfin Type of Construction -r-Ac Occupancy Group 19C Occupancy Load 5oz Fire Sprinklers: ❑Update Existing PpNew SystemN❑Not Req'd Reason Sprinklers Required: '�W1UH %1 I23l3-) Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes 13 No Add] RCW 64.55 docs required prior to final? ❑Yes ®No VALUATION CALCULATION: Total $ Zf -j /07 l LI y K 5 Fxi 130A>f= ='�/87, 72o 5375Fx1}S1/5F = 2'7, 387 If20;/107 Additional Notes: SIn. L e ftj%-TTI�D LL::,-� Approved By: R. /G . Date: /013/Z4a2'L FIRE DEPARTMENT Separate / Deferred Submittals Required: ,lore 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: Q� 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 $ 20/D Calculated: 3 p /0 Credit: Pf<erett School Dist ❑Mukilteo School Dist Additional Notes: �C S - i 2 Z- ��jt s ,4r c- 43 74// - �,r/ �1 3/- ?, z /tom f /� �s n �CG� Sh Approved By: Date: . Z PUBLIC WORKS Intake OK by: Date: 0 7 - ZZ - Zc: L'L Intake Comments: 'PIN Worksheet Needed if' /l%. n ❑Sys Dev Eva[ ®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 BSubmitted 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 q2Z7--1A i ) AND ❑ Is located in this folder 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: Date: