1213 HOYT AVE 2025-04-17 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 8 7-30I -0 2-1 BUILDING LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use 2 ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Addn/Rem Size Total No. of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories 2 ,r--t�� "In Lieu" Fee: Type: Amount$ Basement ❑No l4Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction T12--- Calculated: Credit: Occupancy Group 3.12- ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load --L- Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew System SI.Not Req'd Park Impact Fee Total$ 0 (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ONew System I -Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: ray 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes 1pp1�� No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes friNo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 3'f, $OD Additional Notes: Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: 4QEC-I4cl- 11JSk tLnO t3S ....................... .................. p�{� Intake Comments: PW Worksheet Needed if:(ZeQvI ' ' ❑Sys Dev Eval(Utii/sVV)❑Traffic Mit Eval Approved By: p,v}4 Date: z/14 y.c.t3 ❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) ......................................... Separate/Deferred Submittals Required: ❑Route 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 OCreate 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 0 Is located in this folder 0 Is in a Separate Green Folder Goin with this folder for permit issuance) El Review/Inspection Scope-ADD FIRE FEE 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: Zk.„..