900 PACIFIC AVE BASE FILE 2024-04-11

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#M 3D; `---0 3 -' BUILDING • •ANNiNG intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone VIZ- Overlay/Agreement 1 ❑ Route to Commercial Building Nonresidential Use fYledll CO, ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No.of Dwelling Units: Bldg/Tl/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 1M/2022: Fire Sprinklers: ❑Update Existing ❑New System ❑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 ONot 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 ❑ No ❑ 50%Credit-Issued 0/3/2022-6/2/2023 Add'1 RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$cf j ct>D,, 4)0 Additional Notes: Pn00 ( I /f2 - 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 Date:0,34( ❑Site Work/Drainage :Address 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 ❑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: 0 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 0 is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope---PW Not Required EI_.JCTRICAL/RLUMBII,VG Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: