1815 HOLBROOK AVE 2025-03-06 - Laserfiche WebLink

Intake & Approval Sheet 'FOR PERMIT STAFF ONLY) PERMIT# 1jc�a 11 - 00 BUILDING rLANNING Intake OK by: Date: Intake OK by: l/"e Assign Toll Le Date: 7iii/ 1 f j�j' Intake Comments: Intake Comments: Zone �- l Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use SPg- ❑ Make this a"W" Permit Proposed No. of Dwelling Units: CBId I/Addn/Rem Size 5-36 f)) Total No. of Dwelling Units: Garage/Accessory Struct. Size /eS Planning/Landscape Inspection Required before Final? DYes Cho Number of StoriesZ "In Lieu" Fee:Type: Amount$ rr�� Basement �vNo ❑Yes , Fin/Unfin School Impact Fee: Total s.� jig Ca Type of Construction y/ZCculated: Occupancy Group L Everett School Dist DMukilteo School Dist Occupancy Load /e2 Park Impact Fees for permits ?applied for after 1/1/2022: Fire Sprinklers: DUpdate Existing ❑New System PNot Req'd Park Impact Fee Total$21 SZJ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: DUpdate Existing New System .1.11Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add']RCW 64.55 docs required prior to final? ❑Yes ,EINo VI 0%Credit-Issued 6/3/2023 or later l VALUATION CALCULATION: Total$ O l� Additional Notes: C.I e.0 Gi 4St1 ie t aw�1 cocteti eyH fP�of ed 3 37.3X /6 6 - 934 1 �' peie j ucroAn ce . q6 G6 6 K 3 k 1"6 7/ Approved By: G�v Date: J q 2„eGd ep o $ 3.8 /Yk PUBLIC WORKS Additional Notes: Intake OK by:, Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW) ❑Traffic Mit Eval Approved B . Dat@76/77/f,G' ❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm DOther: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder DSubmitted Previously DDeferred D Permit is Approved by Public Works Fire Dept. Fees: 0-See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required (Permit#: PWL 2 I/ -vu r ) la Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ,,rr�� 0-4s in a Separate Green Folder(join with this folder for permit issuance) Approved By: _ .�wy\ Date: t\-X—�2 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) V ❑ Public Works has no scope--- PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: (f, ! e