2317 BROADWAY 2023-12-06 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# ��,?Of-©D 7 BUILDING • •LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone 1 ,fl y 1 Overlay/Agreement �_ ❑ Route to Commercial Building Nonresidential Use 116 tom/-- + ❑ 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 A- z_ ❑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 D.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 :New System Alot 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 El No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes PNo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ gai b)1 vC) Additional Notes: )/197'/Z; Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: i Date: D k f 12O7j Intake Comments: PW Worksheet Needed if. DSys Dev Eval(Utii/SW) DTraffic Mit Eval Approved B,t al Date:(� /7Z-dam Mite 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 ❑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 0 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 0 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(loin with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) lA Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: +RAAA/14yi ‘ANA/YNYVIA/' O t 0, Approved By: Date: Completed By: 0 Date: 2 v