1019 100TH ST SW 2024-08-06 - Laserfiche WebLink

iu(zire._-ass, p2iiz-G)s Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# F2-(12 —0 3/ BUILDING PLANNING • Intake OK by: ' ' Date: 21 tI Xe 9--� Intake OK by: Assign To: Date: Intake Comments. 1 I Intake Comments: 0 Route to Commercial Building 0 Attach to Project No. f>1/'' 0 1 V Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldgg//TI/Addn/Rem Size 21 a 5 — El Hold in Planning File Drawer bra /Accessory Struct.Size Li /5 $r Zone �Z umber of Stories 2 Overlay/Agreement Basement KINo ❑Yes, Fin/Unfin Nonresidential Use . Type of Construction 'W- Residential Use < ,( , Occupancy Group .5-'(2-e- Proposed No.of Dwelling Units: 1 . Occupancy LoadC Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: 1146 Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes Et No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: VALUATION CALCULATION: Total$ 2115, 5330 C 621I L—o37 Approved By: Date: PUBLIC WORKS-. Intake OK by: Date: Additional Notes: Intake Comments: f;!PWWorksheet Needed if: IOSys Dev Eval ❑Traffic Mit Eval • . iDSite Work or Drainage Proposed Approved By: 12 . Date: ' /L21?p21, ;OBackflow Prevention for high hazard: :(dental,medical,animals,mortuary,hospital, ;supportive housing) i 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 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 Ef-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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: (Q( Jf" Date: u 2, -02 I ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: (247---)