6424 BROADWAY ST VINCENT DE PAUL 2025-07-15

Intake &Approval Sheet (FOR PERMIT STAFF ONL)q PERMIT# BUILDING 1 MINING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use Y ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No.of Dwelling Units: B1dg/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: Credit: Occupancy Group El Everett School Dist ❑Mukiiteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/112022: Fire Sprinklers: []Update Existing❑New 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 EMC19.63.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF vlorksheet req'd for permit? []Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$/0 v ok�2,0 Additional Notes: z Approved By: Date: PUBLIC WORK$ Additional Notes: Intake OK by: Date: .--------------------------- -- ----- --- Intake Comments: ;PW Worksheet Needed if ❑Sys Dev Eval(UHI/sW)ElTraffic Mit Eval Approved Date:ps Yp "bZo USite Work/Drainage l]Address Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT ;supportive housing) - -.-- Separate/Deferred Submittals Required: ❑Route 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: ❑ 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 Qoin with this folderfor permit issuance) Approved By: Date: ❑ Will be issued separately(separate Green Folder,PW Issued ahead of Bldg) Opublic Works has no scope- PW Not Required El]FCTRICALIPLUMBING Additional Notes: Additional Notes: �.(oT r..► 2i,,,,f Approved By: Date: Completed Date: (o p