1027 LOMBARD AVE 2024-02-14 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Z 22-C 2 -O2S BUILDING LANNING Intake OK by: Date: Intake OK by: 'D6. Assign To: Date: t Vtcb '2w1. Intake Comments: Intake Comments: Zone IQ 2. Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use S;titllt ,.f a..414 ele{zt 1 El Make this a"W" Permit Proposed No. of Dwelling Units: t J Bldg/TI/Add /Rem Size 100b Si' Total No.of Dwelling Units: I Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? Yes EINo Number of Stories "In Lieu"Fee:Type: Amount$ Basement ❑No ®-Yes , /Unfin School Impact Fee: Total $ Nth Type of Construction Calculated: Credit: Occupancy Group IQ-C- ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load -CC"- Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System V-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 ONew System 52Not 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 r�No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 does required prior to final? ❑Yes1 In No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ %t/'I i 1 Additional Notes: {.mot} ?.u'k., toptf F.tss Re.✓ CiPAC M•s..uo. $.2. Approved By: i Date: 1 Tclo, Zoi. PUBLIC WORKS ),,,�' Additional Notes: Intake OK by: Date: JLJ\ L Intake Comments: PW Worksheet Needed if: Sys Dev Eval(Util/SW) ❑Traffic Mit Eval Approved B : F'N Date: y'`� pp y �, 3'2fi/zb�3 �jVI W� otPrrX Q I an n i Site Work/Drainage ❑Address Letter Y e. - loelt(� . ❑Backflow Prevention for high hazard: \ (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT vr,�, 1 -lea wIh (/• supportive housing) Separate/Deferred Submittals Required: QSI 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 This Permit is Approved by Public Works Fire Dept. Fees: 21 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(join 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: J� Approved By: Date: Completed By:y l�nn W`of p Bate: 03 12,3 1923 •