2401 LEXINGTON AVE 2025-08-08 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# g c - 0624 BUILDING WINING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone V --3 Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No.of Dwelling Units: Bldg/TllAddn/Rem Size 1330 Total No.of Dwelling Units: Garage/Accessory Struct.Size — Planning/Landscape Inspection Required before Final? ❑Yes ONo Number of Stories "In Lieu"Fee:Type: Amount$ Basement giNo ❑Yes, Fin/Unfin School Impact Fee: Total $ --- Type of Construction IRc. Calculated: Credit: Occupancy Group I R c_. ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load (*LC., Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing❑New System gNot Req'd Park Impact Fee Total$ +'4I.Oo (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System EgINot 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? tt❑DtYes al No El 50%Credit-Issued 0/3/2022-6/2/2023 Add'I ROW 64.55 docs required prior to final? DYes 1No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ ma Additional Notes: DY/Aa, 1(CA/1a QQ 4/000D Approved By: Date: • PUBLIC WORKS • . . Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if ❑Sys Dev Eval(Util/SW) ❑Traffic Mit Eval Approved By: Date: r v R..o2.a. Mite Work/Drainage DAddress Letter II ❑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 OCreate Green Folder ❑Submitted Previously ❑Deferred • 7-1 - This Permit is Approved by Public Works�►► Fire Dept.Fees: 1 See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE 0 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 0oln with this folder for permit issuance) Approved By: Date: El Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) ❑Public Works has no scope--PW Not Required ELECTRICAL/KW/WING Additional Notes: Additional Notes: Approved By: Date: Completed Bye jL Date: Su/ta ZS