1326 55TH ST SW 2025-08-20 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# e3) l.0 '0A6 BUILDING �( ANNINGL fic,Ft VVV Intake OK by: Date: f 01Z f(2/'2 Intake OK by: Assign To: Date: Intake CommentIntake Comments: Zone (0"Zi Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use IE4oute to Residential Building Residential Use 6 f ❑ Make this a"W" Permit Proposed No.of Dwelling Units: Bldg/TI c,6_11 em Size 2G4 cfr Total No.of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes54:1\lo Number of Stories °L "In Lieu"Fee:Type: Amount$ Basement ®No ❑Yes, Fin/Unfin ' School Impact Fee: Total $ Type of Construction 'S-(2-L Calculated: Credit: Occupancy Group 7-e-C ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load L Park Impact Fees for permits applied for after /2022: Fire Sprinklers: ❑Update Existing El New System fL5lNot Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing El New System Not Req'd Permit Technicians:Apply Credit Per MC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/202 9/2/2022 ) "1 • -J RCW 64.55 MF worksheet req'd for permit? ❑Yes No 0 50%Credit-Issued 9/3/2 2-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes IFINo 0 0%Credit-Issued 6/3 023 or later VALUATION CALCULATION: Total$ 95'/®aC0 Additional Notes: O fl C flans 4 Approved By: )t Date: IC),?�,��, PUBLIC WORKS Additional Notes: Intake OK by:'1 V..T Date: to ()Size LZ Intake Comments' PW Worksheet Needed if:eliaukt4�,(,, (J =Sys Dev Eval ❑Traffic Mit Eval Approved By: Fpt Date: \111$I'ZZ VOL! gC cdd'tip;i ❑Site Work or Drainage Proposed DBackflow Prevention for high hazard: m_` Lf NO C w Q AA, (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT Sw SyS -'�ltAu supportive housing) Separate I Deferred Submittals Required: DRoute 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: ►A 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(join 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: Approved By 1Vir Date: mpg g 1 i' i zi;