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IntaKa dc Approval sheet (I-Ot<l-i t<11/11 S I Al- ONLY) PERMIT# 13,9_, --077 <br /> BUILDING • (WINNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> Route to Commercial Building Nonresidential Use <br /> El Route to Residential Building Residential Use <br /> El Make this a"W"Permit Proposed No.of Dwelling Units: <br /> BldglTl/Addn/Rem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes DNo <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement ONo DYes, Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group /?.-- 2— DEverett School Dist DMukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 11112022: <br /> Fire Sprinklers;QUpdate Existing®New System ❑Nofi leq'd Park Impact Fee Total$ (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: OUpdate Existing ®New System ONot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EIVICI9.53.200 <br /> Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF worksheet req`d for permit? , Yes ,Nc ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'!RCW 64.55 docs required prior to final? IKIYes ONo ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$Z7i fJo, 00 Additional Notes: <br /> Approved By: Date: <br /> PUBLIC WoRKs • . <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if: <br /> Clays Dev Eval(Util/SW)DTraffic Mit Eva! <br /> Approved B Date•ptp/zAt ❑Site Work/Drainage ❑Address Letter <br /> ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT supportive housing) <br /> Separate/Deferred Submittals Required: EIRoute this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers OFire Alarm Other: 0This project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND❑Create Green Folder ['Submitted Previously DDeferred <br /> • El This Permit is Approved by Public Works <br /> Fire Dept Fees: El See PW Review Worksheet and associated attached items <br /> L7 Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW <br /> El Minimal or No Fire Scope-NO FIRE FEE AND 0 Is located in this folder <br /> ❑ Review/Inspection Scope ADD FIRE FEE 0 Is in a Separate Green Folder(fain with this folder for permit issuance) <br /> Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> ❑Public Works has no scope--PW Not Required <br /> ELEGTRICAI(PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: • Date: <br />