1416 12TH ST 2025-04-18 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) . PERMIT# W 2-00?`60I BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building El Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments Bldg/TUAddn/Rem Size 6-70 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Z 7-- Number of Stories . I Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction t 1/" 3 Residential Use 6 i l Occupancy Group 1—3 Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: I Fire Sprinklers: ❑Update Existing ❑New System IgNot Req'd -Planning/Landscape Inspection Required before Final? ❑YeMNo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System 161Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑ ep��iYes I_II No ElEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ti No Additional Notes: Aff D' jej, p r, VA.4 IN- }+Iv VALUATION CALCULATION: Total$ Approved By: ly/A.41,A.1 Date: 1,1.S", 2.e 1 , PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: I OSys Dev Eval OTraffic Mit Eval =OSite Work or Drainage Proposed Approved By: — Date: L 01--/ 'OBackflow Prevention for high hazard: =(dental,medical,animals,mortuary,hospital, isupportive 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) El Fire Sprinklers El Fire Alarm DOther: AND ❑Create Green Folder ❑Submitted Previously El Deferred 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 O 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: VI Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: / Approved By: Date: Approved By: C'k Date: \ (( ' - l �/2.--