5419 13TH AVE W 2023-07-31 - Laserfiche WebLink

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# !SAX 0 •-'0.6 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ 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 yy Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu"Fee:Type: Amount$ Basement to ❑Yes, Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group El Everett School Dist ❑Mukilteo Sc ooI Dist Occupancy Load Park Impact Fees for permits appl" for after 1/1/2022: Fire Sprinklers: El Update Existing New System Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calc tion(Year): Fire Alarm: ❑Update Existing ❑New System "11Not Req'd Permit Technicians:Ap Credit Per EMC19.53.200 � 5� Reason Fire Alarm Required: ❑ 100%Credit-I ued 1/1/2022-9/2/2022 t � l `%J RCW 64.55 MF worksheet req'd for permit? DYes ❑ No 0 50%Credit Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 dots required prior to final? ❑Yes ❑No 0 0%Cre it-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 3 SOa O ? Additional Notes: Tale' Approved By: It. Date: 10 •�BLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: { No f w sc.G, ❑Sys Dev Eval ❑Traffic Mit Eval Approved By: Date: /yZ6/t L Mite Work or Drainage Proposed ❑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 ❑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 ❑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 dditional Notes: Additional Notes: Approved By: Date: Approved By: "--.1 Date: pit 41.20 z2,