12001 14TH DR SE 2025-04-18 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) igh PERMIT#_ Z31SZ—D lg BUILDING MI-PLANNING -Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use El Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No. of Dwelling Units: Bldg/-fl/Addri(RRem Siz� (67 I S 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 ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction TV.L Calculated: Credit: Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load 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 ❑New System alot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: t�ipp 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ctNo 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 dots required prior to final? ❑Yes 'Jo ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ SO/WO Additional Notes: 3l 2 Approved By: Date: • PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SVV)❑Traffic Mit Eval Approved By: RQ}.4 Date: q iz/LQ23 OSite Work/Drainage DAddress Letter // ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑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 ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Coin with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ►!4 Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed Byri'k'`S6 Date: 3 4_ s 'L-2,