2523 STATE ST 2026-01-06 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT BUILDING PLANNING Intake OK by: Date: 1 S z 3 Intake OK by_a1r Assign To: Date: �22 Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ® Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a V\C PermLt ❑ OK to Route to Other Departments Bldg/TI/Addn em Size �j�� Si ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone —1Z_ Number of Stories i Overlay/Agreement Basement ®No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use S22 Occupancy Group Proposed No. of Dwelling Units: Occupancy Load 1 Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System allot Req'd Planning/Landscape Inspection Required before Final? ❑Yes o Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ Fire Alarm: ❑Update Existing [I New System Not 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'I RCW 64.55 docs required prior to final? ❑Yes IHNo Additional Notes: VALUATION CALCULATION: Total $ lei I g� 671 sP C -4166jsF = i 1 i�3� OLs tv2 2 ` 22 Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if:__..._..._.............._......................_. i ❑Sys Dev Eval ❑Traffic Mit Eval i ❑Site Work or Drainage Proposed Approved By: Date: Z 7 ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, !supportive housing) ❑Rout this folder e s foer for PW Review at 11.1 end --- PW Revie FIRE DEPARTMENT w 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 Qoin with this folder for permit issuance) ❑ Review/ Inspection Scope-ADD FIRE FEE ❑ Will 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: