916 105TH PL SE 2023-08-01 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 0412 BUILDING •ANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone — I 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 Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories l "In Lieu"Fee:Type: Amount$ Basement EgNo ❑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 permi pplied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System EgNot Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calcu ation(Year): Fire Alarm: El Update Existing ❑New System 2-Not Req'd Permit Technician Use Only:Apply Phase-In 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 -tNo 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'!RCW 64.55 docs required prior to final? ❑Yes to 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 1.2,56'0 Additional Note : Approved By: Date: PUBLIC WORKS Additional Notes: SQ€CwL I 1 Q r7oSOS Intake OK by: Date: Intake Comments: PW Worksheet Needed if:12-6&0 1_E J OSys Dev Eval(Util/SW)❑Traffic Mit Eval Approved By: 9414 Date: Z/t7/�Z3 ❑Site Work/Drainage )]Address Letter / ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end --PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: DThis 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: Completed By: 9 1 Date: %/�/7/ 7/75