2506 LOMBARD AVE 2025-09-29 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT BUILDING . PLANNING Intake OK by:�'�� Date: Op I Z7i Intake OK by�_ Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. fg-Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Add Rem Size Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement o []Yes , Fin/Unfin Nonresidential Use Type of Construction C Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System �kot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New system.-E-Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 49 No ❑Everett School Dist QMukllteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes IgNo Additional Notes: VALUATION CALCULATION: Total$ 170,000 ,approved By: Date: PUBLIC WORKS Intake OK by: ;P4 Date: 9>1 a 1 Additional Notes: Intake Comments: p PW Worksheet Needed if. zEQ,k.s� SFci- a.' N�� Ar++ArGs fl B 1❑Sys Dev Eval ❑Traffic Mit Eval S �o ❑Site Work or Drainage Proposed Approved By: Date: Z 1 g -Z 71 r tiE SC'a Backflow Prevention for high hazard: t(dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT El 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 r ❑Fire Alarm ❑Other: AND ❑Create Green Folder []Submitted Previously ❑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 (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: Ld Public Works has no scope-- PW Not Required Additional Notes: 81 ELECTRICAL/PLUMBINGu- Additional Notes: Approved By: Date: Approved By: Date: