2030 GRAND AVE 2025-04-15 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# ` d g ro°01—. 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-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size ftipt Nonresidential Use Garage/Accessory Struct. Size Residential Use Number of Stories //P Proposed No. of Dwelling Units: Basement ❑No ❑Yes , Fin I Unfin Total No.of Dwelling Units: Type of Construction n Planning/Landscape Inspection Required before Final? ❑Yes ❑No Occupancy Group -4kF' I "In Lieu" Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert. of Occpuancy Required? i4No ❑Yes ❑Shell Only Calculated: Credit: _ Code Year 02021 Ii12018 02015 DEverett School Dist ❑Mukilteo School Dist Fire Sprinklers: DUpdate Existing ONew 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 ONew System Shot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes El No Add'I RCW 64.55 docs required prior to final? ❑Yes ON° Additional Notes: VALUATION CALCULATION: Total $ l 'j Approved By: Date: PUBLIC WORKS Intake OK by: ( Date: Obi 2' K2,` Intake Comments: I PW Review&Worksheet Needed if: I❑Sys Dev Eval: Additional Notes: • DWater ❑Sewer ❑Storm N 0 L. hv./Nam& -1 / PO I❑Traffic Mitigation Eval Approved By: ( , � Date: 9/ yll l i3 I❑Site Work/Drainage(shown/triggered) / f❑Address Letter FIRE DEPARTMENT 1013ackflow Prevention for high hazard: i(dental,medical,animals,mortuary, Separate/Deferred Submittals Required: `hospital,supportive housing) OFire Sprinklers OFire 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 51 Minimal or No Fire Scope-NO FIRE FEE ❑ 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: ,V)(C%i1 c\ Date: 9-)2 3 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) tg Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: � �ti x� Date: 6 I Zz I '2