1410 SEINER DR SOUTH FORK BAKING COMPANY 2025-08-05

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 2 3 0 ®d rj BUILDING LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone mu Overlay/Agreement ❑ Route to Commercial Building Nonresidential ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No. of Dwelling Units: Bldg/Tl/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 Calculated: Credits_. Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew 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$% 2--q/ /q Additional Notes. -0161.1A1CtAl t2,01 ,3 Approved By: Date: • PUBLIC WORKS Additional Notes: Intake OK by: Date: 0'l it 170-0 Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(UtiIISW)OTraffic Mit Eval Approved �� Date:pz,r-e2E3 ❑Site Work/Drainage ❑Address Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/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 0 This Permit is Approved by Public Works Fire Dept.Fees: 0 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 0 Is located in this folder ADD FIRE FEE El in a Separate Green Folder(join with this folder for permit issuance) El Review/Inspection Scope 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 dditional Notes: Additional Notes: *7 A ;fA ©I, ((Q l 2,U 2 Approved By: Date: Completed B Date: 7/�