11020 1ST DR SE 2025-01-28 - Laserfiche WebLink

Intake &Approval Sheet 'OR PERMIT STAFF ONLY) ERMIT# 5 30( -0 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 Add /Rem Size 7°1 5 F Nt v) Total No.of Dwelling Units: ,Garage/$cessory Struct.Size +h..DA„,) 10 5 }F Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu" Fee:Type: Amount$ Basement InNo ❑Yes, Fin/Unfin School Impact Fee: Total $ Type of Construction 14C Calculated: Credit: Occupancy Group '741'(- ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load 4/1Z L Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew System i741 Not Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: El Update Existing ❑New System 11Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: r 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes LJ No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Y1es riNo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Z 2 II , ®/® . Additional Notes:s to-4cl oft f i -( p( -(}y pVt.e. - Ke1-6 Y!t /� � � % S�r�tc r !J) to 3S x66-19�,3 ft7 7 !X �f Approved By: fv i Date: 1O/31 /23 3/7) 3875F i t'vd W PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: 1PW Worksheet Needed if: i❑Sys Dev Eval(UtiuSW)❑Traffic Mit Eval Approved By: \,,L Date: �- Pj a❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT :supportive housing) Separate/Deferred Submittals Required: El Route this folder for PW Review at end ---PW Review Worksheet El Fire Sprinklers ❑Fire Alarm ❑Other: OThis project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred I.This Permit is Approved by Public Works Fire Dept.Fees: 311 See PW Review Worksheet and associated attached items ElReview of As-Built Plans-NO FIRE FEE A Separate PW Permit is Required (Permit#: PW 25 -oc3 ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder i-PJ I S Dig i'f ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Uoin 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---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Date: It2/ /.�Approved By: Date: Completed By: V%( f )7 f