1118 80TH ST SW BASE FILE 2019-12-11

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#siS`15A 0 r b(9 elf BUILPLANNING Intake OK by: Date: (0 i 1FIntake OK by: Date: Intake Comments: Intake Comments: Assign-To:----- To�: ,..---.- r ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Re a er ❑ Make this a"W"Permit 0 OK to Route to Otlyer Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning file Drawer Garage/Accessory Struct. Size Zone A- A Number of Stories Overlay/Agreement Basement ONo ❑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 ONew System ❑Not Req'd Planning/Landscape Inspec '•n Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ONew System ❑Not Req'd School Impact Fee. Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 0 No Additional Notes: , i VALUATION CALCULATION: Total$ 34.-Zejt AO C , 4t, 4 \\tA Approved By 5)E 2 Date: \O I tak j Zoon PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: Nobs./ t$ ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, 40f supportive housing) FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: El Update Existing ONew System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ONew System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existin ONew System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: 'v (?— L Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL /P-4 Additional Notes: Approved By: Date: Approved By: Date: al)