130 W INTERCITY AVE 2025-04-15 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 0 t 2. . 02C0 BUILDING PLANNING Intake OK by: Date: Intake OK by:J Assign To: ijittY IS , Date: I /ic7LI Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ oute to Historic Reviewer ❑ Make thi a"W" 'ermit OK to Route to Other Departments Bldg •ddn/":• Si .. e:/q,i ,tS''`f/0 ,,SI- El Hold in Planning File Drawer Garage • cessory Struct. Size )' Zone Z..> I Number of Stories Z_. Overlay/Agreement Basement lallo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction ✓A Residential Use 51--- Occupancy Group =' Proposed No.of Dwelling Units: Occupancy Load G (VCA/') Total No.of Dwelling Units: 1 Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? es jErNo Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ❑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 X No ❑Everett School Dist ❑Mukilteo School Di Add'I RCW 64.55 docs required prior to final? ❑Yes ,'No Additional Notes: VALUATION CALCULATION: Total$ cS.�Ye0,0(2 g'Gx L/ ` S-/PO 0 x '1l tit, 3° Approved By: G'V� _Date: 4 .2L� 7v2 I PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: iPW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed // €❑Backflow Prevention for high hazard: Approved B � /j-ls Date:C�j/Q;/ �� :(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: AND OCreate Green Folder OSubmitted Previously ODeferred i Additional Notes: This Permit is Approved by Public Works See 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 ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder Uoin 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: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: l''1� Date: !