10209 1ST DR SE 2024-07-05 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT #762?0 ` (.�C� BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/A do Rem Si Garage/Accessory Struct. Size "C—S Number of Stories Basement '®No ❑Yes , Fin / Unfin Type of Construction<2 C Occupancy Group Occupancy Load Fire Sprinklers: El Update Existing ❑New System Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add'I RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ .-O�, i Additional Notes: Approved Byy Date: O 7 r/ 7,-7 L FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL" Additional Notes: Approved By: Date: PLANNING Intake OK bY� Assign To: Date:-2 2 Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: c Approved By: ate: O2 PUBLIC WORKS Intake OK by: Date: .................................,........,,.,.,.,.,.,.......,..,..,.........,................................................................. Intake Comments: PIN WorksheetNeeded if. 1 ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: ;(dental, medical, animals, mortuary, hospital, Isupportive housing) ................. ..... .......................... .. ............................. ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Required Additional Notes: � o scat- i nkri w- Ism, a fW . 2A I2Z Approved By: Date: �Z