5022 DELAWARE AVE 2024-08-02 - Laserfiche WebLink

F. Intake &Approval Sheet DR PERMIT STAFF ONLY) RMIT# -'31 c —o(S7 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: IA Date: B Ur, 2o24 Intake Comments: Intake Comments: Zone R-► ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size Z 2)7? Nonresidential Use _ Garage/Accessory Struct.Size Z 3.S Ct1J v Residential Use 5 FIR Number of Stories I Proposed No.of Dwelling Units: Basement No ❑Yes, Fin/Unfin Total No.of Dwelling Units: I Type of Construction Irt Planning/Landscape Inspection Required before Final? ❑Yes Illivo Occupancy Group "In Lieu"Fee:Type: Amount$ N IA Occupancy Load 'YC (' School Impact Fee: Total $ N I A Cert.of Occpuancy Required? ' No DYes ❑Shell Only Calculated: Credit: Code Year 1:12021 k2018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System INot Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ N IA (net due after credit for existing uses) Fire Alarm: DUpdate Existing ❑New System KINot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add'i RCW 64.55 docs required prior to final? ❑Yes J No Additional Notes: VALUATION CALCULATION: Total$ IV;UJZ7 Approved By: Date: a JAn 202,4 PUBLIC WORKS Intake OK by: ft Date. .. . .$I2d Zj Intake Comments: PW Review 8,Worksheet Needed if: ar uv]c, vJL wily ❑Sys Dev Eval Additional Notes: rlv1F�4 w`f t\ r✓/G`✓�—`^-P z.x3 Sob � �� . OWater ❑SelAtesAlW O a/ 1 L • ❑Traffic Mitigation Eval Approved By: . '1 Date: VI l.-/� fla-' l J ❑Site Work/Drainage(shown/triggered) ` 14 h YdV4 2$hc' ' I OAddress Letter FIRE DEPARTMENT IOBackflow Prevention for high hazard: Separate/Deferred Submittals Required: Ihospitl,medical,r animals,mortuary, hospital,supportive housing) OFire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: ❑This Permit is Approved by Public Works . 0 See PW Review Worksheet and associated attached items Fire Dept.Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is fully digital ❑ 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(join with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) 5 Public Works has no scope on this permit---PW Not Required • ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: tAitAiviT kijyrA,646,‘,.-Date: 11.'lig,107,3