620 112TH ST SE SPACE 17 2024-08-07

Intake &Approval Sheet OR PERMIT STAFF ONLY) :RM►T# BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Commentsm2.2 Zone U V J ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement BIdg/TI/Addn/Rem Size goO l�� Nonresidential Use Garage/Accessory Struct. Size _ Residential Use 191141 11., \-11)01ej Number of Stories l Proposed No.of Dwelling Units: Basement IlNo DYes, Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes ONo Occupancy Group IL "In Lieu"Fee:Type: Amount$ Occupancy Load �L.,, School Impact Fee: Total $ Cert. of Occpuancy Required? ❑No IYes ❑Shell Only Calculated: Credit: Code Year 02021 1112018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: DUpdate Existing ❑New System JRNot 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 ❑New System lNot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add!RCW 64.55 docs required prior to final? ❑Yes El No Addition Notes:4 � �n VALUATION CALCULATION: Total$ '$0,40 0 �—' \ `Q '7/ 1 I /2_1}L_� /z3 Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: FPW Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: OWater ❑Sewer ❑Storm �Q v 'c r rV p i,p 0 DTraffic Mitigation Eval Approved By: (�j fn Date: I��,� �`T I❑Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary, Separate/Deferred Submittals Required: ,hospital,suportive housing)OFire Sprinklers ❑Fire Alarm DOther: Additional Notes: 1VThis 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 Mils located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Coin with this folder for permit issuance) Approved By: •'Rj(pw Date: ❑ Will be issued separetely(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 1 -'' i% y ti' Date: I, `J 7 �j�