4406 S 3RD AVE 2025-11-05 - Laserfiche WebLink

Intake &Approval Sheet t, OR PERMIT STAFF ONLY) rcRMIT#,6 ZgoZ-2qZ BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ❑Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size U A—vcmv Nonresidential Use Garage/Accessory Struct.Size 3,2y SIP t qS—.D S1= Residential Use Number of Stories Z Proposed No.of Dwelling Units:Ll Basement []No RYes, Fin nfin) 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 School Impact Fee: Total $ Cert.of Occpuancy Required? ONo ❑Yes []Shell Only Calculated: Credit: Code Year 02021 IR2018. 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System 9Not Req'd Park Impact Fees for permits applied for after 1/112022: Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: []Update Existing ❑New System ®Not Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes No Add'I RCW 64.55 docs required prior to final? ❑Yes IgNo Additional Notes: VALUATION CALCULATION: Total$ Cpi DO C7 Approved By: Date: Z OF � PUBLIC WORKS Intake OK by: Date: Intake Comments: PIN Review&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: i ❑Water ❑Sewer ❑Storm �OTraffic Mitigation Eval Approved By: Date: Zq z �[]Site Work/Drainage(shown/triggered) I(]Address Letter FIRE DEPARTMENT i11Backflow Prevention for high hazard: '(dental,medical,animals,mortuary, Separate/Deferred Submittals Required: !hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: 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 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 folderfor 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 ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: