2232 12TH ST 2025-12-12 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT# 1 2 Z_ o � o L 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 ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022- Fire Sprinklers: ❑Update Existing ❑New System 14 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 E%ot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 - - -- Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/l/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ®Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add1 RCW 64.55 does required prior to final? RYes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ c�Jw. D� Additional Notes: Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: ---------------------------nta a Comments: :PW Worksheet Needed if. []Sys Dev Eva[(utiitsw)OTraffic Mit Eval Approved B Date: Q 4Ll '[]Site Work/Drainage ❑Address Letter []Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT :supportive housing) '----- --- ------------------------- - Separate I Deferred Submittals Required: ❑Route this folder for PW Review at end - -PW Review Worksheet El Fire Sprinklers El 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(join 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---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: