215 110TH PL SE 2024-11-08 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 6 / / 0�4_ BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No.of Dwelling Units: Bldg/TI/Addn/Rem Size Z -S-IL Total No.of Dwelling Units: Garage/Accessory Struct. Size AIM Planning/Landscape Inspection Required before Final? []Yes ❑No Number of Stories l "In Lieu" Fee:Type: Amount$ Basement ❑No ❑Yes, Fin/Unfin School Impact Fee: Total $ Type of Construction Z Calculated: Credit: Occupancy Group (2C ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load W-C_ Park Impact Fees for permits applied for after 11112022: Fire Sprinklers: ❑Update Existing ❑New System Mot Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): _.._...,__,.. .................._.._... ..,_,,._.,_.,,_,....,.._,....__.._„_..........._................._...........,.._..,...__......................... _., Fire Alarm: ❑Update Existing El New System VNot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/l/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes allo ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? l/❑Yes 9No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 4Pl G (9-C-( Additional Notes: 1�a�40 C4 41U Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: .............._..._..._,...,,..,_........_................,_...,,.....,..............._........ ..,,. Intake Comrents: WIN Worksheet Needed if. • []Sys Dev Eval(util/Sw)❑Traffic Mit Eva] Approved By: ` Date:6 ❑Site Work/Drainage ❑Address Letter Ono L3 ,❑Backflow Prevention for high hazard: No roof A. �A_- �Z3 ;(dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT 1supportive housing) .............._.............................._.._..._......._....____.._..,,_,._.,,_..,.....,, Separate/Deferred Submittals Required: ❑Route 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 This 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 0oin 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 By: Date: