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

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # j�J�Z01 - 0V� 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 157.5 5F Garage/Accessory Struct. Size 501 5F Number of Stories 3 Basement Rho ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing WNew System ❑Not Req'd Reason Sprinklers Required: Ae Fire Alarm: ❑Update Existing []New System Not 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 J]Q No VALUATION CALCULATION: Total $ 5S 7 3 SF x 11v 5,&1 5F x 15, Additional Notes: Approved By: i.k_ 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 LT -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 $ 301V Calc ted: ,30/ a Credit: Everett School Dist ❑Mukilteo School Dist Additional Notes: 7 Z. Approved By: Date: — 2 PUBLIC WORKS Intake OK by: Date: Ci�-22 — 2c LL ......................................................................................................................................... _- ...... Intake Comments: PWWorksheetNeeded if. []Sys Dev Evai ig'rrafric Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: I(dental, medical, animals, mortuary, hospital, Esupportive 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 yt� This Permit is Approved by Public Works See PW Review Worksheet and associated attached items A Separate PW Permit is Required (Permit #: PWZ 2i Z -- ID 2� ) 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: �. �J