2105 BROADWAY 2024-06-21 - Laserfiche WebLink

Intake &Approval Sheet 0R PERMIT STAFF ONLY) •RMIT# 1 ?3 oq 07.7 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone M U ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size 14 09 Nonresidential Use 16 Garage/Accessory Struct.Size Residential Use Number of Stories I Proposed No.of Dwelling Units: Basement No ❑Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes,,'No Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required? No ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 N2018 02015 El Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: El Update Existing ❑New System ®Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: ❑Update Existing El New System CANot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required:RCW 64.55 MF worksheet req'd for permit? ❑ El I [No Add'I RCW 64.55 docs required prior to final? ❑Yes WNo Additional Notes: VALUATION CALCULATION: Total$ '.c,Sb Approved By:"cmi Date: /0 9 23 PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: ❑Water ❑Sewer OStorm I❑Traffic Mitigation Eval Approved By: ()me... y, Date: l / I(j ❑Site Work/Drainage(shown/triggered) l 1❑Address Letter FIRE DEPARTM ENT I❑Backflow Prevention for high hazard: Separate I Deferred Submittals Required: (dental,medical,animals,mortuary, hospital,supportive housing) El Fire Sprinklers El Fire Alarm ❑Other: Additional Notes: ❑This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital gl Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Gobi with this folder for permit issuance) Approved By: S6,tow Date: 10.40 023 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) 121 Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: ,41j;7 rse9 ,,_ Date: to/217ea,