1632 FULTON ST 2023-06-22 - Laserfiche WebLink

Intake &Approval Sheet ei (FOR PERMIT STAFF ONLY) PERMIT# I3 99 C7 96 BUILDING ILANNING _ __ Intake OK by: !- 'N Date: '1 JZb/22- Intake OK by: Assign To: Date: Intake Comments: 1 Intake Comments: Zone (L,..-Z.-- - Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use Route to Residential Building Residential Use 'f ❑ Make this a"W" Permit Proposed No. of Dwelling Units: -- Bldg/TUAddn/Rem Size SGy sF Total No.of Dwelling Units: 1 Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Fi al? ❑Yes No Number of Stories I "In Lieu" Fee:Type: Am t$ Basement ENo ❑Yes , Fin/Unfin ' School Impact Fee: Total $ Type of Construction a(LL Calculated: Cr it: Occupancy Group -O-C DEverett School Dist ❑Muk" eo School Dist Occupancy Load G Park Impact Fees for permi pplied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New SystemeNot Req'd Park Impact Fee Total$ Reason Sprinklers Required: d� Fee Schedule Used For Calculation(Year): Fire Alarm: El Update Existing ❑ 2 New System Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes El No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes i4No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ SSf CDC3 Additional N y Cd' a \�tes.' , ► ! J\V-- "(Z>Al 1 ZZ--064 Approved By: V � . Date: o(,iz.•ZZ F. Ili UBLIC WORKS Additional Notes: Intake OK by: 4._ Date: Ott 2-81242.- isttiot.Oz, cook%V O3 Intake Comments. PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Approved By: peA- Fur- R pH Date: I1 17�Z ❑Site Work or Drainage Proposed 1 ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) 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 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 ) 0 Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder 0 Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(loin with this folder for permit issuance) Approved By: Date: 1 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) _ 14 Public Works has no scope--- PW Not Required ELECTRICAL/PLUMBING' Additional Notes: / I Additional Notes: O"q 1 2Z Approved By: Date: Approved By: uu Date: