2921 HOYT AVE 2024-05-03 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# SZ-1 3--U°.13 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone (n Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use CIO I� r(, Q40�} El Route to Residential Building Residential Use J ❑ 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? DYes El 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 DMukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑U date Existing ❑News stem El Re d Park Impact Fee Total$ p p y q' p (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: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add!RCW 64.55 docs required prior to final? ❑Yes ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional looteess:r a4_CO 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 B Date: /�)/ -/- _DSite Work/Drainage ❑Address Letter DBackflow 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 fiLihis 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 goin with this folderfor 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: Date: Completed B,r7„., Date:sl,t 6`202-3