2526 BROADWAY 2025-07-15 - Laserfiche WebLink

Intake &Approval Sheet 'OR PERMIT STAFF ONLr ,RMIT# 4cks(,_� 0-1 a BUILDING PLANNING Intake OK by: Date: Intake OK b Assign Toje-S5 Date: I q Intake Comments: Intake Comment Zone M U ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement M e}c o eve r 2 tt, z'o t7 5i�ee1 Bldg/TI/Addn/Rem Size ZO ¢uva Nonresidential Use N/A rage/ cessoryStruct. Size k,qc Residential Use PUp) a- SFkZ t e P1�r"`� 1114 Number of Stories Proposed No.of Dwelling Units: 1t%t CA a.,rc, %Y% Basement fpNo ❑Yes, Fin/Unfin Total No.of Dwelling Units: 3 Type of Construction u Planning/Landscapo Inspection Required before Final? ❑Yes ❑No Occupancy Group -G td "In Lieu"Fee:Type: Amount$ 05 Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required? o ❑Yes ❑Shell Only Calculated: Credit: Code Year 102021 �12018 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System E Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ y (net due after credit for existing uses) Fire Alarm: ❑Update Existing ❑New System EqNot Req'd Fee Schedule Used For Calculation(Year): Y� Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes i�l No Add'I RCW 64.55 does required prior to final? ❑Yes LCiNo Additional Notes: VALUATION CALCULATION: Total$ 0 r D-0 Approved By:. Date-] Z,14 PUBLIC WORKS Intake OK by: Intake Comments: PIN Review&Worksheet Needed if: _ ❑Sys Dev Eval Additional Notes: �' i. f tO � k erlt,, - _ ❑Water ❑Sewer ❑Storm ❑Traffic Mitigation Eva[ Approved By: Date: ❑Site Work/Drainage(shownitr'iggered) ❑Address Letter FIRE DEPARTMENT ❑Backflo%v Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, p q hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: ❑This Permit is Approved by Public Works ❑See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#:PW ) ❑Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is located In this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is In a Separate Green Folder(join vith this folder for permit Issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: 'y