628 57TH ST SW 2025-11-07 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLr PERMIT# �2�1 0 r BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: D(M Date: Intake Comments: Intake Comments: Zone 9.2 ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement AiA Bldg/TI/Addn/Rem Size 0 Nonresidential Use Garage/Accessory Struct.Size ' S Residential Use 5 FR Number of Stories �Z• Proposed No.of Dwelling Units: Basement ❑ t No 511Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ®Yes ❑No Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load t School Impact Fee: Total $ 0 200b Cert. of Occpuancy Required? []No MYes ❑Shell Only Calculated: (v,2bb Credit: Code Year 102021 122018 112015 Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System SNot Req'd Park Impact Fees for permits applied for after 1/112022: Reason Sprinklers Required: Park Impact Fee Total 3 I (net due after credit for existing uses) Fire Alarm: El Update Existing El New System El Not Req'd Fee Schedule Used For Calculation(Year): ---_-----_ _. Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes M No Add'I RCW 64.55 docs required prior to final? ❑Yes 1,9No Additional Notes: VALUATION CALCULATION: Total$ u ` ( I b b ;�-OJ; r Tk Approved By: • �� Date: 8 ZO `Y� x b - �u ov q Aenl 2,024 PUBLIC WORKS Intake OK by: Date: Intake Comments: DPW Review&Worksheef Needed if: '[]Sys Dev Eva[ Additional Notes: PPPIN �- (eat ❑Water ❑Sewer ❑Storm DTraffic Mitigation Eva[ Approved By: Date: iEISite Work/Drainage(shown/triggered) DAddress Letter FIRE DEPARTMENT IDBackflow Prevention for high hazard: animals,](dental,medical, Separate/Deferred Submittals Required: !hospital, upportivehousing)rtuary, ❑Fire Sprinklers ❑Fire Alarm ❑Other: i 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 2 401'�� ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital aMinimal or No Fire Scope-NO FIRE FEE 011s located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder aoin with 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 ELECTRICAUPLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: