9540 HOLLY DR 2025-07-17 - Laserfiche WebLink

Intake $ Approval Sheet (FOR PERMIT STAFF ONL-Y) PERMIT # � I 0 BUILDING Intake OK by: Date: Intake Comments: ❑ Make this a "W" Permit ❑ SRC Required (Pre-Insp) I /TI/Addn/Rem Size 00 2 ar e/Accessory Struct. Size lj Number of Stories Z Basement o ❑Yes , Fin / Unfin Type of Construction �— Occupancy Group Z� Occupancy Load Cert. of Occpuancy Required? ❑No `Yes ❑Shell Only Code Year 1112021 M2018 112015 Fire Sprinklers: ❑Update Existing ❑New System MNot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing El New System W Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add'[ RCW 64.55 docs required prior to final? ❑Yes MNo VALUATION CALCULATION: Total $ Z%QQ_ 3)� Tf/ Additional Notes: �� lM`E IL P1A_*1 Approved By: V` Date: C)Z FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: q Date: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: Zone d1z / Overlay/Agreement �y Nonresidential Use Residential Use Proposed No. of Dwelling Units: i Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final?Yes ❑No "In Lieu" Fee: Type: _ Amount $ School Impact Fee: Total $' 1127 Calculated: / /---) Credit: f!!� ❑Everett School Dist ukilteo School Dist Park Impact Fees for permits applied for after 1/1/2022: Park Impact Fee Total $ _ 7> S J� (net due after credit for existing uses) Fee Schedule Used For Calculation (Year): -2 C _Z `� I'll Additional Notes: Approved By: Date: t — i U "c PUBLIC WORKS Intake OK by: Date: Intake Comments: ...................................... ._....................... ....,.,,.................,,_..,.....,...,.,,.,,.,,, PW Review & Worksheet Needed if: -Qs4 WSys Dev Eval : ❑Water ❑Sewer IRStorm L iOTraffic Mitigation Eval ®Site Work/Drainage (shown/triggered) ❑Address Letter ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, supportive housing) This Permit is Approved by Public Works ® See PW Review Worksheet and associated attached items ® A Separate PW Permit is Required (Permit #: PW 29o`I - JS `i ) AND ,� Is fully digital ❑ Is located in this folder ❑ Is in a Separate Green Folder Coin with this folder for permit issuance) ❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope on this permit --- PW Not Required Additional Notes: Completed By: ja, Date: Z C Z v l