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

Intake & Approval Sheet •(FOR PERMIT STAFF ONLY) PERMIT# 82367-- ()(0i BUILDING ANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement (5P\i i ,�D� 1'& o 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 3 "In Lieu" Fee: Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group r(--2_ ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for perm)ts applied for after 1/1/2022: Fire Sprinklers: DUpdate Existing ONew System i Not Req'd Park Impact Fee Total$ c.2) (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation (Year): Fire Alarm: ❑Update Existing ❑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 In No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ENo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total $7 000 CCU Additional Note : ) ii/75- Vsl Aide 2/ Approved By: Date: • PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)OTraffic Mit Eval Approved B ni� Date: 92/27�7h7"3 ❑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 ❑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 Gain with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) 0 Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: