11201 3RD AVE SE 2023-09-27 - Laserfiche WebLink

Intake &Approval Sheet FOR PERMIT STAFF ONLY) ip PERMIT# 52305 00 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 Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu"Fee:Type: Amount$ Basement ❑No ❑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 permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing New System Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing 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? ,JYes ❑ No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add]RCW 64.55 docs required prior to final? 'IYes ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: €❑Sys Dev Eval ©Traffic Mit Eval Approved B Date 7/ /'7,eZ3 DSite Work or Drainage Proposed IDBackflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT ;supportive housing) Separate I Deferred Submittal's Required: DRoute this folder for PW Review at end ---PW Review Worksheet El Fire Sprinklers El 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 Gan 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 Additional Notes: Additional Notes: Approved By: Date: Approved By: Date: