1027 LOMBARD AVE 2024-02-14 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#?J io '-cam 3,..3 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a "W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size n/J t ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size V14 Zone Number of Stories / Overlay/Agreement Basement ❑No EYes , Fi Nonresidential Use • Type of Construction 1 i2-e_ Residential Use Occupancy Group L i2 Proposed No.of Dwelling Units: Occupancy Load ,r. Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing Mew System EINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing El New System IJNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑ TA- No El Everett School Dist ❑Mukilteo School Dist Add!RCW 64.55 docs required prior to final? ❑Yes tNo Additional Notes: _ VALUATION CALCULATION: Total$ ,5 ` . C�� CI�>J :6 3E- _ 7e,27) Approved By: �t'r Date: /tom// PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: ilt /7 U44,41c4-0_, IOSys Dev Eval ❑Traffic Mit Eval C/Lt it,, 13,4 fz574,,„,,,-a I❑Site Work or Drainage Proposed i` ❑Backflow Prevention for high hazard: Approved By: C�� Date: ►0 /z [ _(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred Additional Notes: ❑ This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder la Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/ Inspection Scope-ADD FIRE FEE � El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) 1 Approved By: Date: !2 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: