11031 19TH AVE SE 2023-06-12 - Laserfiche WebLink

Intake &Approval Sheet Ali (FOR PERMIT STAFF ONLY) PERMIT# t3 ZZ 09) BUILDING �LANNING BU ING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone (Y U Overlay/Agreement • ❑ Route to Commercial Building Nonresidential Use . arro( c rote ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Addn/Rem Size Total No. of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu" Fee:Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(iear): Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technicians:Apply Credit Pr EMCI9.53.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022 9/2/2022RCW6455MFworksheetrq'dforpermit? YesNo ❑ 50%Credt- ssued9 /20226/2/2023Add' RCW64.55docsrequredpriortofnal? YesNo ❑ 0%Credt- ssued6 /2023r later VALUATION CALCULATION: Total$ Additional Notes: (�r;kn 1 I ()(VJ/27 Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑TraffiProposed c Mit Eval ❑Site Work or Drainage / ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 0 This Permit is Approved by Public Works Fire Dept. Fees: ❑ See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE 0 A Separate PW Permit is Required(Permit#: PW ) ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Approved By: Date: