1026 LOMBARD AVE 2025-07-14 - Laserfiche WebLink

• • Intake &Approval Sheet (FOR PERMIT STAFF ONLY) 411 PERMIT# 1322-03-00-I BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: - Intake Comments: • ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size t 0 Ll' 0 Hold in Planning File Drawer Garage/Accessory Struct.Size !` 9 a Zone V.Z. Number of Stories Overlay/Agreement Basement ElNo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction crige.. Residential Use %.,-LANY Occupancy Group cc- Proposed Proposed No.of Dwelling Units: Occupancy Load cG •�y" Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System iNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ailo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: DUpdate Existing ONew System ?Not Req'd School Impact Fee: Total $ 45ee. C_IS J Reason Fire Alarm Required: ,�( Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes L5 No ❑Everett School Dist ' ❑Mukilteo School Dist Add''RCW 64.55 docs required prior to final? ❑Yes ,...._US Additional Notes: >�U (G ) ri �cbyjq.4}Rj w�'Id- VALUATION CALCULATION: Total$ 10 ,000 thoo) Cy^ __ v;�OAC�..��,•�y(''��A� Zb1Sfpry tom; t'S rbGr'CZ IL 1 Approved By: ( . ,, Date: `3."2-�a -?��-- PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: PW Worksheet Needed if: 5 1 0,,f� 0C' 1USys Dev Eval OTraffic Mit Eval I❑Site Work or Drainage Proposed e Approved By: Date: 5 A1r.,?-� OBackflow Prevention for high hazard: / (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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: This Permit is Approved by Public Works IK See PW Review Worksheet and associated attached items I Fire Dept.Fees: • El A Separate PW Permit is Required(Permit#: PW' 2O'-O25 ) ❑ Review of As-Built Plans-NO FIRE FEE AND ritIs located in this folder 1KIMinimal 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 �J 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:�,��(` )y� Date: 3 d29 32.2 0 Public Works has no scope PW Not Required Additional Notes: go s {Am i$ F00-4- of buAtY ELECTRICAL c\ro,tA Si Azek l aF 10, Additional Notes: J Approved By: Date: Approved By: akil Date: 1\21)\aial Z/Z