1726 100TH ST SW 2025-11-07 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# BUILDING PLANNING Intake OK by: Date: -Maas i Intake OK by: Assign To: Date:09 Z Intake Comments: Intake Commen 5orne rw,nor correc}tons needed,bu+ nothing ino.- W'►l S�9r�'�rec4,n+lt� a1tCr- the de5i9n,$o rev',ews offer &0-, OIC I-o vy%o re 40r-ward. ❑ Route to Commercial Building LAttach to Project No.REV 122- OZ _ ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments fBldg I/Addn/Rem Size 17'+L4 ❑ Hold in Planning File Drawer a rage/Accessory Struct.Size Lf 1 LA Zone Number of Stories 2 Overlay/Agreement N/A Basement RNo ❑Yes, Fin/Unfin Nonresidential Use N/A Type of Construction Residential Use 5 F R Occupancy Group C Proposed No.of Dwelling Units: 1 (6 2 on 10+ Occupancy Load Total No.of Dwelling Units: 1 (0� 2. on to* Fire Sprinklers: ❑Update Existing ❑New System RNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Iallo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing El New System 13Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 9 No ❑Everett School Dist �Mukilteo School Dist Add'I RCW 64.55 docs required priorto final? ❑Yes BNo Additional Notes:Needs b u'4t d-%n of �iei�h'r Cal Gvl0.�t 0n S. VALUATION CALCULATION: Total$ 2-L171 3 3"1 ZO ZZ Park ke: A-2 ,,B n 1106P IV3F �L-f 5*--A 2201-7 20 1 7P) Approved By: Jessica J arY1 Date: D9/23/ZZ 51 '&A y l`� s f = � -1 I �L1?/ g?j L( - PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if. • []Sys Dev Eval ❑Traffic Mit Eval E❑Site Work or Drainage Proposed Approved By: G Date: (p�� €❑Backflow Prevention for high hazard: ((dental,medical,animals,mortuary,hospital, Isupportive 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 []Fire Alarm ❑Other: AND QCreate 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 (L241-O ZZ ) ❑ 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: p J-1\ Date: Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By Date: g (f1j l 2Q2?i