11020 20TH DR SE 2025-01-13 - Laserfiche WebLink

Intake & Approval Sheet i• (FOR PERMIT STAFF ONLY) • PERMIT# 622-bs - 0 1 5 BUILDING PLANNING Intake OK by: Date: _ Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone U123 ❑ Make this a"W" Permit 0 SRC Required (Pre-lnsp) Overlay/Agreement '�2t-*- eoE oil.dal 1rair•siir Bldg/TI/Addn/Rem Size Nonresidential Use 4./A Garage/Accessory Struct. Size Residential Use Con dO (fi1ttNipte.Ufl t3) Number of Stories Proposed No. of Dwelling Units: 05 Basement ❑No ❑Yes , Fin/Unfin Total No. of Dwelling Units: C 1t)ttzl ei,, parcel) Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes IZINo Occupancy Group TILL, "In Lieu" Fee: Type: t /p, Amount$ d1/N Occupancy Load School Impact Fee: Total $ N�(� Cert. of Occpuancy Required? ONo ❑Yes ❑Shell Only Calculated: Nor Credit:__ RI/k Code Year I.2021 02018 02015 DEverett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑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$ N/IN (net due after credit for existing uses) Fire Alarm: ❑Update Existing DNew System Not Req'd Fee Schedule Used For Calculation(Year): NI A Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? DYes 3 No Add'I RCW 64.55 docs required prior to final? oyes No Additional Notes: VALUATION CALCULATION: Total $ f Of 'J�� Approved By: � Date: per/23/2_620 PUBLIC WORKS Intake OK by: Date: Intake Comments: I PW Review&Worksheet Needed if: i❑Sys Dev Eval : Additional Notes: DWater ❑Sewer ❑Storm c ❑Traffic Mitigation Eval Approved By: L t1 Date: (.)( Z 5 �4 '❑Site Work/Drainage(shown/triggered) El Address Letter FIRE DEPARTMENT i❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: =(denta medical,animals, mortuary, !hospital,supportive housing) El Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: 0 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 ❑ Minimal or No Fire Scope- NO FIRE FEE 0 Is located in this folder O Review/Inspection Scope-ADD FIRE FEE 0 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: