9634 19TH AVE SE A 2024-01-08 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # 5ZZ'U 1— b 5 g BUILDING Intake OK by: Iz• Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size S41 SF - Number of Stories 3 Basement ®No ❑Yes , Fin / Unfin Type of Construction Occupancy Group 4" Occupancy Load Fire Sprinklers: ❑Update Existing WNew System ❑Not Req'd Reason Sprinklers Required: e le ale" Fire Alarm: ❑Update Existing []New System ®Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes M No Add'I RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ Z a✓ I� 1 /573 s 1= x /3olst= _ , 4/ LI 10 $!ol 5f= x A $i/SF=0Z3,troll 2r33,ro► Additional Notes: 5/Ny1,6 PL#qfJr-p L-of Approved By: ,e."%t _ Date: /0/,2 FIRE DEPARTMENT Separate / Deferred Submittals Required: ire 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 Eg Review / Inspection Scope - ADD FIRE FEE Approved By: Date: '�- 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 $ `So/O Calculated: 30� Credit: L�JEverett School Dist ❑Mukilteo School Dist Additional Notes: %�u, j /�"i rQ Approved By: Date: -'L3 PUBLIC WORKS Intake OK by:. Date: C? - ZZ - Zs: L) .................................................................................................._. _ ................_ .. Intake Comments: PWWorksheetNeeded if. • ❑Sys Dev Eval Traffic Mit Eval []Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: I(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 JESubmitted 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 22 p_ --� lU) AND ❑ Is located in this folder 14 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: