4021 FRIDAY AVE 2025-09-11 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONL)q PERMIT BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone 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/TI/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 (t2G ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permit plied for after 1/1/2022: 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): 1 _ ......_...,..__ _,..... .._,-...................... ,....,.._,........,.__,.........,_.._..,_..,_..,.._.. Fire Alarm: Update Existing El New System yuNot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: rt� ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Addl RCW 64.55 docs required prior to final? ❑Yes MNo ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 24,t=:257 Additional Notes: n Lha L Z23- Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: ........... ____,_,.,._....__.._.........__......,....,..... ,. .............. . Intake Comments: ;PW Worksheet Needed if: ![]Sys Dev Eval(UGI/sw)(]Traffic Mit Eval Approved By: Date: OE]Site Work/Drainage ❑Address Letter IDBackflow Prevention for high hazard: I (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) i------------........._...........................................,................... Separate/Deferred Submittals Required: El 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) EFPublic Works has no scope—PW Not Required ELECTRICAL/PLUMBING Additional Notes: RPOLT> 5vzFAcE iA�EA• Additional Notes: Approved By Date: Completed By: — Date: c.•S 20 2oL3