1101 GRANDVIEW AVE 2025-08-07 - Laserfiche WebLink

/2Q I sWA L 6 Intake & Approval Sheet (FOR PERMIT STAFF ONLY) W PERMIT# 3 /i --too? BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To:J Q,S S Date: /7/z 3 Intake Comments: Intake Commen s: Zone _ R—( ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Lor,nec,i-oc- 5i'rce+- Bldg/TI/Addn/Rem Size Nonresidential Use N/A Garage/Accessory Struct. Size Residential Use SF Number of Stories \ Proposed No.of Dwelling Units: ( (RDL)I Basement ❑No ❑ es, Fin/Unfin Total No.of Dwelling Units: 2 Z�vv Type of Construction Planning/Landscape Inspection Required before Final? ❑ Ei Yes No Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ 0 Cert.of Occpuancy Requir ? ❑No ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 02018 02015 DEverett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑ date Existing El New System El Not Req'd Park Impact Fees for permits a plied for after 1/1/2022: .�I�eo•d� c�s5e5se Reason Sprinkl s Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: ❑Update Existing DNew System ❑Not Req'd Fee Schedule Used For Calculation(Year): Reason ire Alarm Required: RC 4.55 MF worksheet req'd for permit? ❑Yes ❑ No d'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ �R'D Approved By: 7 Date: 1% 1 7 /Z 3 PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: 't�t7/�"t3 CuvLT EX t f•Sc,+/ DWater DSewer ❑Storm �j ❑Traffic Mitigation Eval Approved By: Date: 02/n./Z,3 ❑Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,por animals,mortuary, p q hospital,supportive 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 40 Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Uoin with this folder for permit issuance) Approved By:' i?- Q` /r Date: ( " '?) ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope on this permit--- PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: