12815 19TH AVE SE 2024-02-14 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) ' PERMIT#14,1-3 d 7—0125 BUILDING IPLANNING 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: DUpdate Existing El New System El Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 dots required prior to final? ❑Yes ❑No ❑ 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: IPW Worksheet Needed if: ❑Sys Dev Eval DTraffic Mit Eval Approved By: Date: !Mite Work or Drainage Proposed DBackfow Prevention for high hazard: ,(dental,medical,animals,mortuary,hospital, FIRE DEPARTMENTsupportive housing) Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers DFire 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 ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder coin 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: 2 Date:7- '.-Z3 Approved By: Date: