905 80TH ST SW FORMOST FUJI 2024-10-07

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # - L - O(f BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size 7z-N Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction r' _ 6 Occupancy Group -/ Occupancy Load Fire Sprinklers: MUpdate Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: Update Existing El New System El Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No Add] RCW 64.55 docs required prior to final? ❑Yes o VALUATION CALCULATION: Total $ 45C5. 000_ 00 Additional Notes: Approved B Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: Fire Sprinklers 'Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE Review/ Inspection Scope - ADD FIRE FEE proved By: Date: v2- r ELECTRICALIPLUMBING Additional Notes: Approved By: Date: BANNING Intake OK by: Assign To: Date: Intake Comments: Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "in Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated:}- Credit: El Everett School Dist ❑Mukilteo School Dist Park Impact Fees for permits applied for after 1/112022: Park Impact Fee Total l /,joy (net due after credit for existing uses) Fee Schedule Used For Calculation (Year):-20 23 --0` -------------------------------------------------------------------------------- Permit Technician Use Only: Apply Phase -In Credit Per EMC19.53.200 ❑ 100% Credit- Issued 1/l/2022 - 9/2/2022 • 50% Credit - Issued 9/3/2022 - 5/2/2023 ❑ 0% Credit - Issued 6/3/2023 or later Additional Notes: Approved By: ;. , e-'*X__--Date: _ _ PUBLIC WORKS Intake OK by: Date: - ----------I------------------------------ Intake Comments: ; PW Worksheet Needed if: ❑Sys Dev Eva[ (Util/SW) ❑Traffic Mit Eval (]Site Work/Drainage ❑Address Letter I]Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, :supportive housing) ----------------------------------------- ❑Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder Coin with this folder for permit issuance) ❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Required Additional Notes: Completed Byr__ Date: 1 161 zi' Z Z -