1701 121ST ST SE 2023-12-11 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# U 1301- b� I BUILDING 1 •LANNING intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone I Overlay/Agreement ` ` r ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use - I U I 4iPtijrit� ❑ 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 3 "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 permi applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew System alNot 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 t3Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes pi No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? DYes Ea No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 7000-DIa Additional Notes: NUJ I Approved By: Date: • PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if.• ❑Sys Dev Eval(Util/sW)[]Traffic Mit Eval Approved B e Date:oz-/l�Z,ot 3 OSite Work/Drainage DAddress 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 0 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 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 ❑A Separate PW Permit is Required(Permit#:PW ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder El in a Separate Green Folder(join with this folder for permit issuance) ❑ 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: 2-17—