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

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) PERMIT# d 7 — On BUILDING "PLANNING Intake OK by: Date: Intake OK by:r Assign To:3e SS Date: I 1 I /Z'3 Intake Comments: Intake Comme ts: Zone MU Overlay/Agreement Coosn"tc)cer- Street- 0 Route to Commercial Building Nonresidential Use okc k ce-g El Route to Residential Building Residential Use ►.1/A ❑ Make this a"W" Permit Proposed No. of Dwelling Units: N/A Bldg/TI/A i/ Siz 7 b J 7 ,,,* Total No.of Dwelling Units: t,i/A Garage/Accessory Struct. Size if/a Planning/Landscape Inspection Required before Final? ❑Yes No Number of Stories - "In Lieu"Fee: Type: Amount$ Basement Elo ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction 1/23 Calculated: Credit: Occupancy Group /3 ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Y8 Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ElUpdate Existing El 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: Iilpdate Existing El New System ❑Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: 1 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes in No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes EINo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total $3/S//4/Z.6 Additional Notes: Approved By: Date: I hi I f Z o Z 3 v � PUBLIC WORKS Additional Notes: Intake OK by: 610 Date: 11t.�b)26�z Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)[]Traffic Mit Eval Approved B . zd Date:b�/y/?bp3 ❑Site Work/Drainage ❑Address Letter ❑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 'ire Sprinklers OFire 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: 0 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 0 Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: t64-e)WcDate:2 45,, ,3 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) 111 Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: '",,i.�► - Additional Notes: / i A� �yv lz- i3.2z5v Approved By: Date: CompletedP:y: Date: