3315 BROADWAY HOPEWORKS STATION 2 2026-01-15

Intake & Approval Sheet (FOR PERMIT STAFF ONLY _ PERMIT # 4� 0�, � 7� BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction —r-A Occupancy Group Occupancy Load Fire Sprinklers: MUpdate Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: M Update Existing ❑New System ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes rD No Add'I RCW 64.55 docs required prior to final? ❑Yes 21No VALUATION CALCULATION: Total $qj-a von A v Additional Notes: Approved B Date: 10,Z FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm Additional Notes: A/oY I Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE inimal or No Fire Scope - NO FIRE FEE ❑ Review / Ins pection Scope - ADD FIRE FEE Approved B : - Date: /d Z- 0-z . ELE TRI AL/PLU BIN Additional Notes: Approved By: Date: ILANNING Intake OK by: Assign To: Date: Intake Comments: Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection. Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: []Everett School Dist ❑Mukilteo School Dist Park Impact Fees for permits applied for after 11112022: Park Impact Fee Total $ Fee Schedule Used For Calculation (Year): Permit Technicians: Apply Credit Per EMC19.53.200 ❑ 100% Credit- Issued 1/l/2022 - 9/2/2022 ❑ 50% Credit - Issued 9/3/2022 - 6/2/2023 ❑ 0% Credit - Issued 6/3/2023 or later Additional Notes: Approved By: Date: 10 202_,Z PUBLIC WORKS Intake OK by: Date: "(/ MtiZ Intake Comments: ;PWWorksheet Needed if. • �LC� p p 10 ; I]Sys Dev Eva[ ❑Traffic Mit Eval ; OSite Work or Drainage Proposed ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, supportive housing) ------------------------------------------ ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit'is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (loin with this folder for permit issuance) ❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Required Additional Notes: AMAJ-9 ]A Approved B : Date: