16 76TH ST SW 2025-08-20 - Laserfiche WebLink

Intake $ Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#�2 _00 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign Date: 7 Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement Bldg/TI dd /Rem Size Nonresidential Use Garage/Accessory Struct.Size Residential Use 6j/0407J Number of Stories Proposed No.of Dwelling Units: g Fjcdrso►++s Basement ©No ❑Yes , Fin/Unfin Total No.of Dwelling Units: Type of Construction �t Planning/Landscape Inspection Required before Final? ❑Yes No Occupancy Group T k— "In Lieu"Fee:Type: Amount$ Occupancy Load ilk School Impact Fee: Total $ n /Q Cert.of Occpuancy Required? ❑No ©Yes ❑Shell Only Calculated: Credit: Code Year 122021 112018 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Park Impact Fees for permits applied for after 1/112022: Reason Sprinklers Required: Park Impact Fee Total$ rt (0, (net due after credit for existing uses) Fire Alarm: El Update Existing []New System q Not Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'I RCW 64.55 does required prior to final? ❑Yes QNo Additional Notes: VALUATION CALCULATION: Total$1t) uUo Approved By: , Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed If: h Q 4) I� ❑Sys Dev Eval ❑Water []Sewer []Storm Additional Notes: ��+►�^'„,`,._ , �'� 11Z� 1� ✓ ❑Traffic Mitigation Eval Approved By: , )'t ,. Date: -I []Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, Se p q hospital,supportive housing) El 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 L.Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join Wth this folderfor 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: 11�� y Additional Notes: ►� pyA 4%t4 l t5 pt 'k V`Gnvk 7° P�l''�i 1�Y � Approved By: Date: Completed By; Au0YL#n Date: 61j 1 4 U7, ap-VW?A01 'D iti I kid,k,a I Q f�W6 . JAW�k k✓t►*ln 01 (to 1m I .