2605 15TH ST 2025-04-18 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 030 3 'O S BUILDING • •ANNiNG Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Li Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use i XiI"t m.t- Home V e ❑ Make this a"W" Permit Proposed No.of Dwelling Units: Bidgffl/AddnlRem Size 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 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 ONew System ❑Not Req'd Permit Technician Use Only:Apply Phase-in Credit Per EMC19.53.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ales ❑—t No ❑ 50%Credit-Issued g/3/2022-6/2/2023 Add'1 RCW 64.55 docs required prior to final? ❑Yes ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: 'lai t4a_120 Approved By: • PUBLIC WORKS ' Additional Notes: intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/sW)❑Traffic Mit Eval Approved By- Dateep,06A ❑Site Work/brainage 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 ❑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 0 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(loin with this folder for permit issuance) Approved By: 61 Date: 5 Et/j$,j rrr�yyP�� Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) I..�. ublic Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By Date: 0 3f2 �3