10101 7TH AVE SE BLDG 1 2025-11-03

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#t= LOr--P30(�— e BUILDING , ,-ANNING c.-b& 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 M1 A El Make this a"W"Permit Proposed No. of Dwelling Units: Bldg/TI/AddniRem Size -'r-t2 Total No,of Dwelling Units: GaragelAccessory Struct.Size — PIanning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories In Lieu"Fee:Type: Amount$ Basement WNo ❑Yes, Fin/Unfin School Impact Fee: Total $ Type of Construction V- Calculated: Credit: Occupancy Group Z ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 11112022: 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): .. ................................................................ ... .... Fire Alarm: Update Existing ❑New System ❑Not Req'd Permit Technician Use Only:Apply Phase-in Credit Per EMC19.53.200.. Reason Fire Alarm Required: I-1 ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? Yes ❑ No El 50%Credit-Issued 9/3/2022-6/2/2023 Add9 RCW 64.55 docs required prior to final? ❑Yes 2No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ S5 o Additional Notes: '5 Z Z�5 • �� Ov0 PApoved By: Date: PUBLIC WORKS Additional Notes: intake OK by: Date- -------------------------- --------------- Intake Comments: IPW Worksheet Needed if: ❑Sys Dev Eval pysW) ElTraffic mit Eval Approved By: r Date: 'ClSite Work/Drainage E lAddress Letter i L ;❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT ;supportive housing) `----- ------- ----------------------------- Separate Deferred Submittals Required: ❑Route this folder for PW Review at end —PWRevievv 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 Goin with this foiderfor permit issuance) Approved By: Date: ❑Wili be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑Public Works has no scope—PW Not Required ELECTRICALIPLUMBING Additional Notes: [Approved dditional Notes: By: Date: Completed By: Date: