701 75TH ST SE BLDG 5 SHORESIDE VILLAGE 2025-04-23

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# ?22o3 —CA15 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a "W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size £t4'iVU1 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement 'NNo Yes , Fin/Unfin Nonresidential Use Type of Construction -nKt \) Q.5 Residential Use -F Occupancy Group I�v Proposed No. of Dwelling Units: 1/0 C,,/.UNJVQi Occupancy Load �� Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System gNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: 14Update Existing ❑New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr RCW 64.55 MF worksheet req'd for permit? ❑ VI 1�'.I No ❑Everett School Dist ❑ ilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 123No Additional Notes: VALUATION CALCULATION: Total $ 27)10(30. o% Approved By: Date: d PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval I❑Site Work or Drainage Proposed ppBy: ,I�, p ( I y I I r�,^2,� ❑Backflow Prevention for high hazard: Approved I `ice Date: `t �C J (dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 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 located in this folder Minimal or No Fire Scope- NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By4'.,Q L-{-01(1 I‘-e.) Date: 1'III I2-2— Of Public Works has no scope--- PW Not Required 0 Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: