1026 LOMBARD AVE 2025-04-16 - Laserfiche WebLink

1111° Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# (giOs O BUILDING PLANNING Intake OK by: Date: /�1 zitle Intake OK by: Date: )2d I t — �Intake Comments. G� t�� , 1 Intake Comments: Assign To: e -- ,E..cvt.--nl eft Yr ❑ Route to Commercial Building i Attach to Project No. C y�\C\ - ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ottOK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone s1 /'t Cu.l '\ Number of Stories 2 9ver+sy cae eFit(S**eec L9e6 CJ\C\AA€c, Basement �No Oyes, Fin/,__1 Nonresidential Use �l Type of Construction V - '; Residential Use Occupancy Group Proposed No. of Dwelling Units: M Occupancy Load ,23 Total No. of Dwelling Units: (I\ \ L 'Cs vl1/4- � Q Fire Sprinklers: ❑Update Existing ❑New System NNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes 121.No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: El Update Existing ❑New System KNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 ME worksheet req'd for permit? giYes ❑ No El Everett School Dist ❑Mukilteo School Dist. Add'I RCW 64.55 docs required prior to final? 1.1Z1Yes El No Additional Notes: VALUATION CALCULATION: Total$ O29 Approved Bcy•! Date: PUBLIC WORKS Intake OK by:` .) Date: 8/2_i/J g Additional Notes: Intake Comments: PW Worksheet Needed if: C S ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: . At?, Date: l0126- GR ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, We dl A 9 supportive housing) pp FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,N-• Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preli ary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project T-am ❑ This Permit is Approved by Public Works Date: (OK t' `oute to Other Departments) ❑ See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update "xisting ❑New System ❑ Not Req'd ❑A Separate PW Permit is Required(Permit#: PW Fire Alarm: ❑Up:ate Existing ❑New System ❑ Not Req'd AND ❑ Is located in this folder Chemical Sup: 11. pdate Existing El New System ❑ Not Req'd ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Additional No s: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approve. :y: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: