1101 GRANDVIEW AVE 2025-08-07 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# pa /(--- ()D Q i BUILDING PLANNING �, Intake OK by: M�ik Date: 0 `ill- Intake OK by: Assign To: ��s5 Date: I I/04/2Z Intake Comments: Intake Cofmf�'1me6 s:Bring\n ko LU r,s ng to de+eris,,;ne. W non contce r %5 Ler+k lco.4''or\ is fecesso.- . Zone �J Overlay/Agreement Connechr S ree7,5►iewalkpriort .ireu ❑ Route to Commercial Building Nonresidential Use NIA ig Route to Residential Building Residential Use SFQ + ADV ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/T Addn Rem Size Zq/ S F Total No. of Dwelling Units: 2. Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories y "In Lieu" Fee:Type: Amount$ Basement _❑No EYes Fri Unfin School Impact Fee: Total $ Type of Construction r Calculated: Credit: Occupancy Group SF—C- DEverett School Dist ❑Mukilteo School Dist Occupancy Load .TR-€'_ Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: El Update Existing ❑New System glNot 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 ElNot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: �1 CI 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes Et No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? -v❑ �`r Yes 1No ❑ 0%Credit-Issued 6/3/2023 or later v VALUATION CALCULATION: Total$ 0,000 Additional Notes:Loa-la use APO AQpVicGk'iori c Qproved t1/Z 3/ZZ Approved By: Date:p3 I Z8 /Z3 PUBLIC WORKS Additional Notes: Intake OK by7-11,4T Date: I OD /06 2„2— I nta ke Comments: ;PW Worksheet Needed if. (4,14(.101 V«C r! Sys Dev Eval(Util/SW) ❑Traffic Mit Eval Approved By: * Date: Li 1 Z ex,Sdire55 l,(fi Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: El Route this folder for PW Review at end ---PW Review Worksheet El Fire Sprinklers El 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: 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 4 Is located in this folder Et/Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By:/("„e5 ,,_,n Date: �� a ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) -/—„2. ❑ Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By T 4 .; Date: b q'II 2/,79J/