1920 100TH ST SE 2026-01-12 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PER AIT# BUILDING PLANNP G Intake OK by: Date: Intake OK by: Assign To: 3 CSS"ic0. Date: I� ZCq ZZ Intake Comments: Intake Comme t Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use M 6, 1'i fa v-,i I ❑ 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 f r after l/1/2022: Fire Sprinklers: El Update Existing ❑New System El Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System []Not Req'd Permit Technicians:Apply Credit Per EMC1 .53.200 Reason Fire Alarm Required: - ❑ 100%Credit-Issued 1/l/2022-9/2/202 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/202 Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ ?yam ° Additional Notes: Approved By: Date:I 0 Z(c /Z Z i PUBLIC W RKS Additional Notes: Intake OK by: Date: - ------------------------------------ Intake Comments: ;PW orksheet Needed if.• OS s Dev Eval ❑Traffic Mit Eva] Approved B ,�j�^ - Date: /B ,� 7�C'L ;❑Se Work or Drainage Proposed A ❑B ckflow Prevention for high hazard: (dentk medical,animals,mortuary,hospital, FIRE DEPARTMENT ;supp�rtivehousing) '---- ------------ ----------------------- Separate I Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate conCL rrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submi ed Previously ❑Deferred ❑This Permit is Approved by Public W rks Fire Dept. Fees: El See PW Review Worksl and asso iated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Piermit#: 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 N t Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Approved By: Date: