2216 GRAND AVE 2025-09-11 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#� 2,209 - Og5 BUILDING PLANNING Intake OK by: P)r\ Date: Z Intake OK by: Assign To: Date: I Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. M-Route to Residential Building ❑ R ute to Historic Reviewer El Make this a "W" Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size L)AC o n � ,� Hold in Planning File Drawer Garage/Accessory Struct. Size Zone nn�f Number of Stories LZ c f�44h Overlay/Agreement Basement El No &Yes Cin Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System QNot Rea'd Planning/Landscape Inspection Required before Final? ❑Yes []No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ❑New System QNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑Everett School Dist ❑Mukilleo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: VALUATION CALCULATION: Total $ «/3 S• o Z Approved By: Date: ( Z� PUBLIC WORKS Intake OK by: Date: Intake Comments: Additional Notes: �PW Worksheet Needed If., 5f ^EC-1 A i._ I R1S PELT 1G U �Ct'i�v t�L� tOSys Dev Eval ❑Traffic Alit Eval p IF I` 1—9LO S",9 Cam{`;C__ -Lo 1 ) f❑Site Work or Drainage Proposed Approved By: Date: 41 6 ZL �13Backflow 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) El Fire Sprinklers El Fire Alarm ❑Other: 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 ❑ Minimal or No Fire Scope- NO FIRE FEE ❑ Is in a Separate Green Folder coin 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: ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: 2�