3003 W CASINO RD BLDG 40-27 2025-05-28

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 4KZ.S7e29—o$5 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required (Pre-lnsp) Overlay/Agreement t, Bldg/TI/Addn/Rem Size Nonresidential Use SOG1(LQ' �r. 1Wrt '�'C�.#'1�oY1 Garage/Accessory Struct. Size " Residential Use �J Q V eAI l- Number of Stories Proposed No.of Dwelling Units: Basement ONo ❑Yes , Fin/Unfin Total No. of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? DYes ONo Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required? IKIJ"Jo ❑Yes ❑Shell Only Calculated:_ Credit: Code Year 02021 142018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing El New System EiNot 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 El New System l Not Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ED No Add'I RCW 64.55 docs required prior to final? ❑Yes Jo Additional Notes: 1 nn In1 o I/� �7 VALUATION CALCULATION: Total$ '�X.0`�, � c�� 1 Vr<�I/[1JCJ� `V `Z' Z2 Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: jPW Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: ❑Water ❑Sewer ❑Storm ❑Traffic Mitigation Eval Approved By: C gjA. Date: I / I,;)1.3 ❑Site Work/Drainage(shown/triggered) DAddress Letter I FIRE DEPARTMENT !❑Backflow Prevention for high hazard: (dental,mu Separate/Deferred Submittals Required: ;hospital, t supportiveanimals,mortuary, housing)' ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: 0 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 ❑ Is located in this folder 0 Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) Approved By: Date: t ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) L1 Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING 'Additional Notes: Additional Notes: Approved By: Date: Completed By: �` Date: q/ 5/z.