613 40TH PL 2025-04-22 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# P3 C.r - OZfl BUILDING • •ANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone V.-- Overlay/Agreement 0 Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use ff-,-} ❑ Make this a"W"Permit Proposed No.of Dwelling Units: Bldg/TI/Addn/I�em Siz :ESN`f Total No.of Dwelling Units: Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu"Fee:Type: Amount$ Basement No EYes, Fin Unfin School Impact Fee: Total $ Type of Construction -`0--L Calculated: Credit: Occupancy Group -^( - ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load 42-L Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System ' Not.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 ONew System IIot 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 !!No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes 1�71Vo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ LIS,abo Additional Notes:2-na 1Ut ✓1 dal 1 cal l4ed GU/ IJrYl4,4l(lalI /27J772 AT—}+ Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: P--44 Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval Approved By: 9_2 44 Date: 24 lizlzo-L3 Mite Work/Drainage ❑Address 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 ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder OSubmitted 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 ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(loin with this folder for permit issuance) 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: