11201 3RD AVE SE 2019-08-13 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Pj(G1 d-t BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size p 4 D Hold in Planning File Drawer Garage/Accessory Struct. Size Zone 12 — Number of Stories 2.- Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use i(V'U 11 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 LJNo 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 El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: •, VALUATION CALCULATION: Total$ IZi "tom Approved B . Date: / / 211 q PUBLIC WORKS Intake OK by: FJ 7 Date: C /Z Additional Notes: Intake Comments: PW Worksheet Needed if: 17er-'K'e-gS-TA-AdarkG'O Crt_zziou,se.t Ok.h-y) ❑Sys Dev Eval CI Traffic Mit Eval e.o>,1 ^ Aar RrseRi7 LSite Work or Drainage Proposed Approved By: ,i 1/ Date: 1112//1 ❑Backflow Prevention for high hazard: . (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT EIRoute 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 ❑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: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Gre n Folder(join with this folder for permit issuance) O Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separa ly(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 14 Public Works has no scope--- W Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: .pproved By: Date: