2232 12TH ST 2025-09-30 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 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 ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/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 ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not 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 ❑Mukilteo School Dist Add1 RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: ��" VALUATION CALCULATION: Total$_ '93�3 00 • - � Approved By: 14,H Date: PUBLIC WORKS Intake OK by: . Date: Additional Notes: Re:F015F 7o ytEEan�,,� QQy Intake Comments: FWWorksheet Needed if. • ).rip tNhc s L LSCIG+-f �c Pv�6� p,�Rt,�pt 11]Sys Dev Eval ❑Traffic Mit Eva[ RE�Copp OSite Work or Drainage Proposed Approved By: Date: fOBackflow Prevention for high hazard: ;(dental,medical,animals,mortuary,hospital, (supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheets r�r Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers ❑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 Qoin v4lth this folderfor 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 Additional Notes: Approved By: Date: Approved By: Date: