1525 75TH ST SW CASCADE COFFEE 2025-04-23

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) PERMIT# B 221 -- 0 41 BUILDING 'PLANNING Intake OK by: Date: Intake OK by: / Assign To: S 2SS Date: I/l I/Z3 Intake Comments: Intake Comme s: Zone L2 2 Overlay/Agreement AMA+ACA,Paine Fieta sub Arta _ ❑ Route to Commercial Building Nonresidential Use iA)arenovse ❑ Route to Residential Building Residential Use _ fa^ ❑ Make this a"W" Permit Proposed No. of Dwelling Units: N/A BIdgITI/Addn/Rem Size Total No.of Dwelling Units: N� Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes)ONo Number of Stories "In Lieu" Fee: Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers:,Update Existing ONew System ❑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: Update Existing DNew System El Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 Reason Fire Alarm y Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes , No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ CS-009e 9 Additional Notes: Approved By: i Date:1/(1 /23 PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval Approved Date:e 5yo i...5 OSite Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive 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 0 This Permit is Approved by Public Works Fire Dept. Fees: 0 See PW Review Worksheet and associated attached items El 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 0 Is located in this folder Review/Inspection Scope ADD FIRE FEE 0 Is in a Separate Green Folder coin with this folder for permit issuance) Approved By:fl Ed-oC ,c Dater-& ❑ 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: