555 PILCHUCK PATH 2025-08-14 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# BUILDING I LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone 2A Overlay/Agreement O Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use 6P12, ❑ 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 "In Lieu"Fee:Type: Amount$ Basement ❑No ❑Yes, Fin/Unfin School Impact Fee: Total $ /- Type of Construction L'/-C Calculated: Credit: Occupancy Group Zf2C. ❑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 [Not 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 ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$S 1 a°• 6 J Additional Notes: (.01 I l3 )f) 1 fx4ha,t/L 1114/2s Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed 1f ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval Approved Bak,z5,Z17 Date: C2 6/27/76 ❑Site 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 ❑Submitted Previously ❑Deferred it-This Permit is Approved by Public Works J mpg Fire Dept.Fees: (IS( See PW Review Worksheet and associated attached items Cc,❑ 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(join with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) gPublic Works has no scope--PW Not Required EL.ECTRICAUPLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By'� �„ Date:vq /tej fzet