2621 GRAND AVE 2025-04-15 - Laserfiche WebLink

si! Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY). PERMIT# v 2003 `02 4 BUILDING PLANNING Intake OK by1 ,M Date:O//riZ®Z0 Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. El Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size /2 q 6 Sk ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone U(2-. Number of Stories Z. Overlay/Agreement P4f Q (6 Basement ❑No ®Yes,OUnfin Nonresidential Use Type of Construction -ES Residential Use db J CitL. Occupancy Group 1Z. Proposed No.of Dwelling Units: -- Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes to Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ Fire Alarm: ❑Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes IA No ❑Everett School Dist ❑Mukilteo School D. t Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: 4,4 11)/"' (e)(4,c - 1 req• ( '' ) VALUATION CALCULATION: Total$ 12.5lt COO Lk or o eo, o� paA- 1� aki s ee?v1 -; Co0A5 ('* ba�Sem,enl- a 0.r� J Pi 5 � At5k�1 Approved By: IL tei Date: 3 j'3_�Z v PUBLIC WORKS Intake OK by: T - Date: 3/1.3 d 2-626 Additional Notes: 20/S /Rc * j4 SIEC Intake Comments: I PW Worksheet Needed if: �. 9#.1-tEtt-46 t+—wo RAC '(]Sys Dev Eval ❑Traffic Mit Eval �� 0 Site Work or Drainage Proposed "p 4 . S core E Approved By: jii' Date:3`2 / j OBackflow Prevention for high hazard: �( I(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT DRoute 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: 0 This Permit is Approved by Public Works ❑ 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 0 Is located in this folder ❑ 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: Date: I Public Works has no scope---PW Not R quired Additional Notes. as/oar 2oZn ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 2/2_