5005 SPERRY LN 2024-11-15 - Laserfiche WebLink

Intake &Approval Sheet OR PERMIT STAFF ONLY) 4,MIT# O ('3 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: J e.Ss Date: i I/I 5/23 Intake Comments: Intake Commen ,. Zone R-1 ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement w/A Bldg/Tl/Addn/Rem Size Nonresidential Use N/A Garage/Accessory Struct.Size — Residential Use 5 F R Number of Stories Proposed No.of Dwelling Units: N/A Basement ©No ❑Yes, Fin/Unfin Total No.of Dwelling Units: I Type of Construction 'S`� Planning/Landscape Inspection Required before Final? ❑Yes No Occupancy Group Lk' "In Lieu"Fee:Type: Amount$ 0 Occupancy Load T. C. School Impact Fee: Total $ 0 Cert.of Occpuancy Required? PNo ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 112018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing El New System Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ 0 (net due after credit for existing uses) Fire Alarm: ❑Update Existing El New System logNot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes 5 No Add'I RCW 64.55 dots required prior to final? Oyes No Additional Notes: VALUATION CALCULATION: Total$ 15 •Ob Approved By Date: 11/15/2.3 PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed if: ❑Sys Dev Eval: • Additional Notes: D [�/ OWater OSewer ❑Storm ��W ` `' . DTraffic Mitigation Eval Approved By: L 4e„„„^ Date: I Vey )3 ❑Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,por animals,houi mortuary, p q hospital,supportive housing) ❑Fire Sprinklers ❑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 El Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE 0 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 on this permit---PW Not Required • ELECTRICAL/PLUMBING Additional Notes: Additional Notes: / Approved By: Date: Completed By: Date: 1(/ 7 (. ij7,72,