10830 19TH AVE SE A & B 2024-06-13

Intake &Approval Sheet 4IbR PERMIT STAFF ONL19 •ERMIT# ( 2 Z 0 5— 01 Co BUILDING PLANNING pp Intake OK by: Date: Intake OK by:MS Assign To: '.D• Date: 5l /ZZ" Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑''oute to Historic Reviewer ❑ Make this a"W"Permit 'g`.K to Route to Other Departments BI g/TI/ ddn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone i1 r ` U Number of Stories / Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use &WE tee- Type of Construction / Residential Use Occupancy Group 067 Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El Update Existing El New System .. Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing Chew System Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes cgtNo ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes EgNo Additional Notes: VALUATION CALCULATION: Total$.roOO,0° Approved By: tom' 1 ' Date: C/Z GlZ.2.._ PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: IOSys Dev Eval ❑Traffic Mit Eval `❑Site Work or Drainage Proposed Approved By. r�4�' Date: m6 o3 Z"L 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: -This Permit is Approved by Public Works ISee 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 0 Minimal or No Fire Scope-NO FIRE FEE 0 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:W.1154yj��, \ Date: Cp -mr-7 0 Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved y: Date: 5/-zf-zozz 217i