1432 LOMBARD AVE 2025-03-07 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#c-6 21 k 0— 02g BUILDING PLANNING��,,"" Intake OK b¢- �.,''1• Date:/�0,.8/��/ Intake OK by:OleAssign To: Tr4l($. Date: z /' 4 Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size oi n Zone f Z- Number of Stories Overlay/Agreement DOrlekail11 1 kc.pcstrkk4- Basement ❑No ❑Yes, Fin/Unfin_ _ Nonresidential Use Type of Construction \1(f..C� Residential Use SF 11L Occupancy Group \it C Proposed No.of Dwelling Units: Occupancy Load \iJ Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ®Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: rvf "In Lieu" Fee:Type: Amount$ Fire Alarm: El Update Existing El New System Io1Not 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$ "l t / ILC� Grp` Approved By: I I l3 ��2 Date: I (ikvy 110t M� VON� PUBLIC WORKS �1/1�� Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval � � r lOSite Work or Drainage Proposed Approved By: .., Date: ` f 2''(1201 i1/ =❑Backflow Prevention for high hazard: 1 :(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 OFire Alarm ❑Other: AN ❑Create Green Folder OSubmitted Previously ❑Deferred Additional Notes: This Permit is Approved by Public Works 1s ee PW Review Worksheet and associated attached items Fire Dept. Fees: LV A Separate PW Permit is Required (Permit#: PW ZttlZ—c/Z) r ❑ Review of As-Built Plans-NO FIRE FEE AND R'Is located in this folder 0 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: ` 1 Approved By: Date: Approved By: , Date: 1✓ '/ t)1 ` ♦