4520 S 3RD AVE 2025-12-12 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �Z r Cog 'bZ BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To:_W L. Date: -20Z Intake Comments: Intake Comments: 0 ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a" ermit OK to Route to Other Departments Bldg/TI/Add ze ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone —Z Number of Stories 2 Overlay/Agreement Basement o ❑Yes , Fin/Unfin Nonresidential Use Type of Construction zff 2c, Residential Use SF F Occupancy Group C Proposed No.of Dwelling Units: Occupancy Load 6 Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System FINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System fnNot Req'd School Impact Fee: Total $. Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist " Add'1 RCW 64.55 docs required priorto final? ❑Yes `L No Additional Notes: No eX:-kffG( Wplr��d( D(Gt�p+� e_M VALUATION CALCULATION: Total$ �T coo.D b W, �h-1J4�S IOeCyyt�f- Approved By: Date: PUBLIC WORKS'` Intake OK by: Date: :,.._ .._..._...._...,.........-._............................ ......,.._.......,.....,_.. Additional Notes: Intake Comments: JPW Worksheet Needed if. • '! ]Sys Dev Eval ❑Traffic'Mit Eval El Site Work or Drainage Proposed Approved Date:�� /f Z- > ❑Backfiow Prevention for high hazard: ;(dental,medical,animals,mortuary,hospital, €supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers ❑Fire Alarm ❑Other: AND [ Create Green Folder ❑Submitted Previously ❑Deferred 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 located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder Coin vAth this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑WIII be issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope—PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 9-