1522 PINE ST 2024-02-20 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# W 2i1O 3 "003 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ?too Sf ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone --2-► Number of Stories 2-- Overlay/Agreement Basement ❑No , Yes, Fin/Unfin Nonresidential Use E, Type of Construction V& Residential Use C�,,Q�JL4J_i..4 r t`. . Occupancy Group !2--3 Proposed No.of Dwelling Units: — Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 13(No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: VALUATI CALCULATION: Total$ / zI6. Ott' d�c ,fe,30kJ-56 iCk,e,c`,,�-JVIt/1 Approved By: _1() Date: )j,I .art PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: I❑Sys Dev Eval DTraffic Mit Eval =OSite Work or Drainage Proposed Approved By' Date:O��'�/ (]Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route 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) ❑Fire Sprinklers El Fire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously ❑Deferred Additional Notes: J ❑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 ❑ 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 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ' Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Mk Date: it0 t 124