5404 S 3RD AVE 2024-04-12 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# g21Og"0( - BUILDING • . . PLANNING • • • Intake OK by: Date: Intake OK bp/6Assign To:f 1 I , , Date: EA 1 /2cL i Intake Comments: Intake Comments: ►1edWI iands/cLe. 1v2a1d1 atcaS co ±e °rG erfy, weal Marea' on Uvilc4 - cv4(- °( ofro.i.spo . ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer (0r(CC /1 Hc ❑ Make this a"W"Permit %K to Route to Other Departments &a+8/12/2 it Bldg/II/Add em ' e /'Z i,'F 0 Hold in Planning File Drawer Garage/Accessory Struct.Size it//4 Zone TT--I Number of Stories / Overlay/Agreement Basement E2No ❑Yes, Fin/Unfin Nonresidential Use . Type of Construction - L--/,'.? Residential Use Sf . Occupancy Group Z/2( Proposed No.of Dwelling Units: Occupancy Load 6 • Total No.of Dwelling Units: Fire Sprinklers: DUpdate Existing ❑New System N Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ENot 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 docs required prior to final? ❑Yes ®No Additional Notes: VALUATION CALCULATION: Total$ 6•5 d' DD Approved By: Af> Date: 02.2.,/,,----,f ,., . , PUBLIC WORKS'` Intake OK by: Date: _ ___ _ ___ Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed• Approved By. 1 / Date:0 /J 7,oz/ ❑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 I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers OFire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously ODeferred Additional Notes: J . 0 This Permit is Approved by Public Works . :: • 0 See PW Review Worksheet and associated attached items Fire Dept.Fees: 0 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 0 Is in a Separate Green Folder Coin with this folder for permit Issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 1,2Public Works has no scope--- PW Not Required Additional NNO es: Pte- ELECTRICAL (h1,` c,e ,J,c -cry- S•rdi S .e..4- ea-it-full I Additional Notes: +v ete-S rV4uo: i ef-.. oc/L Approved By: Date: Approved y v Date: g(3( 1 Z �162.„