3904 FEDERAL AVE B 2025-08-07 - Laserfiche WebLink

Intake & Approval Sheet I FOR PERMIT STAFF ONLY) ERMIT#92) )32)O(Q —W2-- BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Da Date:24 USX 201 Intake Comments: Intake Comments: Zone R ❑ Make this a"W" Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg/TI/Addn em Slz° 740 Nonresidential Use Garage/Accessory Struct. Size Residential Use 2 CMS A Dv Number of Stories Proposed No.of Dwelling Units: Basement ❑No ®Yes , Unfin Total No. of Dwelling Units: Type of Construction `2r Planning/Landscape Inspection Required before Final? DYes JEINo Occupancy Group 1g - "In Lieu"Fee:Type: Amount$ Occupancy Load I School Impact Fee: Total $ def Cert. of Occpuancy Required? ❑No DYes DShell Only Calculated: Credit: Code Year 02021 Ig2018 1=12015 ❑Everett School Dist DMukilteo School Dist Fire Sprinklers: ❑Update Existing New System ®.Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: — Park Impact Fee Total$ 2112,D (net due after credit for existing uses) Fire Alarm: DUpdate Existing New System Not Req'd Fee Schedule Used For Calculation(Year): SeleS Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? DYes No Add'I RCW 64.55 docs required prior to final? ❑Y-s ®No Additional Notes: 0.4.4i W.try61 p '.s Fmk,' pu,,+,3,, VALUATION CALCULATION: Total $ ,..•C� ftq v�`t�ct� f EAAC 11(�,_34,OSb• C.• �l Approved By:L044,4.1/0,lf' C.1 Date: TA d c,t ?.oL; SO CUODAN. PUBLIC WORKS ��✓��✓t Intake OK by: Date: ........................................................................................................................................................ tt�take Comments: 1PW Review&Worksheet Needed if: i❑Sys Dev Eval: Additional Notes: DWater ❑Sewer ❑Storm ❑Traffic Mitigation Eval Approved By: Date: I2/t J 3 I❑Site Work/Drainage(shown/triggered) / ❑Address Letter FIRE DEPARTMENT (❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: !(dental,medical,animals,mortuary, p q hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: EQ-- his Permit is Approved by Public Works LL—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 with this folder for permit issuance) Approved By:yt j.J-Nn Date: I — i 7 ❑ 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 , r J � — Date: fa, f j A f�-zA