1429 BROADWAY 2025-04-11 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# l&`o.3b Le- ©(e BUILDING ! •LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone M t) Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use iflec ca,Q o(4'CILI ❑ Route to Residential Building Residential Use Make this a"W"Permit Proposed No.of Dwelling Units: BldglTllAddnlRem 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 ONo QYes, Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group ❑Everett School Dist DMukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew System ❑NotReq'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: El Update Existing :New System El Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per ENICI9.53.200 Reason Fire Alarm Required: r—t El 100%Credit-Issued 1/1/2022-9/2J2022 RCW 64.55 MF Worksheet req'd for permit? DYes ❑No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'l RCW 64.55 does required prior to final? LDYes ❑No El 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$/- I� 43 Additional Notes: /0/C14 Approved By: Date: PUBLIC WORKS • . . . Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if; ❑Sys Dev Eval(U6Vs1n) ❑Traffic Mit Eval Approved t Dat /p/ 4 zjj ❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, •FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: El Route this folder for PW Review at end --Phil Review Worksheet El Fire Sprinklers Er Fire Alarm Other: EIThis project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ®Submitted Previously ❑Deferred El This Permit is Approved by Public Works Fire Dept.Fees: El See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW ) El Minimal or No Fire Scope-NO FIRE FEE AND d Is located in this folder fi-Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: ,9)Col d n Data: _6 _23 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) /v/c 2 3 Q Public Works has no scope--PW Not Required EIXCTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: • Date: 2I2