10521 19TH AVE SE ALLIED TELESIS INC 2025-03-27

Intake &Approval Sheet Aik(FOR PERMIT STAFF ONLY) PERMIT#!yI ZOZ -O 07 BUILDING111, • •LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone _ i Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use / (LQ)( re- -�Q ❑ 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? DYes ❑No Number of Stories "In Lieu"Fee: Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ C 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 ❑Not Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing El New System ❑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 ❑ No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No 0 0%Credit-Issued 6/3/2023 or later//�� VALUATION CALCULATION: Total$ n406°-6(0 Additional Note : i/I y hlf7/IOj2t 3I30/3 1, SI7 /'A d B : Date: pp Y PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(utilISW)❑Traffic Mit Eval Approved Bk Date(VTJf J'C62� ❑Site Work/Drainage DAddress Letter ❑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 0 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: 0 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 0 Is located in this folder 0 Is in a Separate Green Folder(join with this folder permit issuance) El Review/Inspection Scope-ADD FIRE FEE 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: Completed By: Date: