1111 PACIFIC AVE 2025-01-10 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# �ZU'' on BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required(Pre-lnsp) Overlay/Agreement Bldgrfl/Addn/Rem Size Nonresidential Use Garage/Accessory Struct.Size Residential Use Number of Stories Proposed No.of Dwelling Units: Basement ❑No ❑Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes ❑No, Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required? lit5No ❑Yes ❑Shell Only Calculated: Credit: Code Year &021 02018 ❑2015 DEverett School Dist ❑Mukilteo School Dist Fire Sprinklers: DUpdate Existi g New System .Not 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: El Update Existing ❑New System pNot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes 171No Add'l RCW 64.55 does required prior to final? ❑Yes IgNo Additional Notes: VALUATION CALCULATION: Total$ (,j i IN a Q Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: IPW Review&Worksheet Needed if: t ❑Sys Dev Eval: Additional Notes: ❑Water ❑Sewer ❑Storm R ( i OTraffic Mitigation Eval Approved By: L tv 1)a.�I�w iM Date: $131 ) L Site Work/Drainage(shown/triggered) I lIDAddress Letter FIRE DEPARTMENT 1❑Backflow Prevention for high hazard: (dentaSeparate/Deferred Submittals Required: hospital, medical,p r animals,houi mortuary, hospital,supportive housing) El 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 ❑ 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: