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

Intake & Approval Sheet (FOR PERMIT STAFF ONLr PERMIT BUILDING Intake OK by: A r, Date: b/31 kn Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size $F Garage/Accessory Struct. Size Number of Stories 3 Basement EQNo Yes, Fin / Unfin Type of Construction 3-tC Occupancy GroupTV-C Occupancy Load 94-11, Fire Sprinklers: ❑Update Existing New System ❑Not Req'd Reason Sprinklers Required: AlWYA6 3l3 11 Fire Alarm: ❑Update Existing ❑New System IqNot 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 WNo VALUATION CALCULATION: Total $ Z I Si IC)-7 /q gi-1 5 F x t 3c> 53-7 sr- X si Additional Notes: Approved By: 14v, Date: lW 3,12022 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 2eview / Inspection Scope - ADD FIRE FEE Approved By: t Date: lD 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 $ `3p/a Calc ted: 34>10 Credit: -&— Everett School Dist ❑Mukilteo School Dist Additional Notes: / /u �� eS� `T 'Z Z i .LG Approved By: Date: PUBLIC WORKS Intake OK by:e:f� Date: 0-if - Z Z - Zcs Z 2� ............................................................. ............. _....... ................_................._.._...._ 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 BSubmitted Previously ❑Deferred This Permit is Approved by Public Works See PW Review Worksheet and associated attached items 0 A Separate PW Permit is Required (Permit #: PW ZZ.� AND n❑ Is located in this folder Uu Is in a Separate Green Folder Coin 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: By: Date: I