2105 MCDOUGALL AVE 2025-05-23 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# UJ - U LIT BUILDING PLANNING Intake OK by: `' Date: Intake OK by: Assign To: L. Date: Intake Comments: Intake Comments: Zone -2. ❑Make this a"W"Permit ❑ SRC Required (Pre-In ) Overlay/Agreement Bldg/TI/Addn/Rem Size SG0 Nonresidential Use Garage/Accessory Struct.Size Residential Use g v SL } -p le K Number of Stories Proposed No.of Dwelling Units: — Basement I*• • ❑Yes, Fin/Unfin Total No.of Dwelling Units: rj Type of Construction g Planning/Landscape Inspection Required before Final? ❑Yes No Occupancy Group - / "In Lieu"Fee:Type: Amount$ 0 Occupancy Load School Impact Fee: Total $ O Cert.of Occpuancy Required? VICE ❑Yes ❑Shell Only Calculated: Credit: Code Year021 02018 1:12015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ v (net due after credit for existing uses) Fire Alarm: CI Update Existing El New System [Apt Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? Ves ❑ No Add'I RCW 64.55 docs required prior to final? ❑Yes gNo Additional Notes: VALUATION CALCULATION: Total$ �f/ 000 / Approved By: Date: 5/3 i J z -i i / PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: ❑Water DSewer OStorm ' I t❑Traffic Mitigation Eval Approved By: ,, �/ _Date:• -I �j �� ❑Site Work/Drainage(shown/triggered) DAddress Letter i FIRE DEPARTMENT DBackflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, Se pq hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: ❑This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑A Separate PW Permit is Required(Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital Minimal or No Fire Scope-NO FIRE FEE ❑ 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?,'>--j,,li\ Date:5..,..2,2-,2 4 ❑ Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: C.,t '/-/A z-f