928 HOYT AVE 2025-04-15 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# .V 7i3o ( ` 0 U7 BUILDING • LANNING �Intake OK by: Qk Date: k ,2.42023 Intake OK by: /'/f/(7 Assign To:44 Date: 2—/q12- 3 Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use i Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No. of Dwelling Units: Bldg/T/Add?Rem Size S F Total No.of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories I "In Lieu"Fee: Type: Amount$ Basement ❑No ihYes ,6T9 Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group DEverett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: El Update Existing ONew System ENot 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 El New System CatJot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC79.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add!RCW 64.55 docs required prior to final? DYes INo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 20 C7 Additional Notes: Approved By:66, Date: 3 /1 / )Z. • PUBLIC WORKS ` Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval Approved By: ?P°(-k, Date: \/2bf-ZB-2 ❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate I Deferred Submittals Required: DRoute 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 ❑This 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#:PW ❑ Minimal or No Fire Scope-NO FIRE FEE AND 0 Is located in this folder ADD FIRE FEE El in a Separate Green Folder Qoin with this folder for permit issuance) El Review/Inspection Scope Approved By: Date: ❑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: