1919 112TH ST SW 2019-08-20 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 11J(g it' .0 21 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 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone sic-2j 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: Cre ' : RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No El Everett School Dist ❑Mu . eo School Dist Add!RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: geflemeaepirr em-- 4.0 k„t_ e kuj 0,,,_VALUATION CALCULATION: Total$ etb'bAs� a 1 �7aftel lee5 c �y yib_ pn4a J C r\�N \ Ae - 4 Approved By: � acA Date: U. R7-4 PUBLIC WORKS Intake OK by: JE:Sc--. Date: 1111517.�$" Additional Notes: Intake Com -f ts: PW Worksheet Needed if: AW ❑S s Dev Eval ❑Traffic Mit Eval iora i r/ / y ❑Site Work or Drainage Proposed Approved B ► Date: ❑Backflow Prevention for high hazard: pp Y'- ��0�%s (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute 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: ❑Update Existing ONew System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ 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: 111144.61g, J