9632 19TH AVE SE E 2023-12-19 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # PM-0- JZ I BUILDING Intake OK by: Ale- Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size /5 -73 SF Garage/Accessory Struct. Size S601 SF Number of Stories 3 Basement O�No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing WNew System El Not Req'd Reason Sprinklers Required: %t ,&tfamr IZ313'i Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? []Yes -1j] No Add'I RCW 64.55 docs required prior to final? ❑Yes U No VALUATION CALCULATION: Total $ 33, �0 15773 5r x le0 666 x s I Additional Notes: Approved By: . Date: /01.3/ZD ZZ- FIRE DEPARTMENT Separate / Deferred Submittals Required: ,Ozire 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:4�_ 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 $ ?o/C., Calculated: j g , 6 Credit: tP ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: j: �, ;t J:u f�c1 J 9 —,� Approved By: Date: PUBLIC WORKS Intake OK by: Date: 07 �1 2ZZZ ........................................................ ..... ...... ................................... ................. -........ _..._.. _ .. Intake Comments: PW Worksheet Needed if. (Sys Dev Eva[ ®Traffic Mit Eval ❑Site Work or Drainage Proposed f❑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 R1 This Permit is Approved by Public Works See PW Review Worksheet and associated attached items A Separate PW Permit is Required (Permit #: PW 2.21`)2^0) D ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: [Approved By: Date: OS I b1 .