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intake de Approval sheet (l-LJI- I—L tod i 1 S I AH- ONLY) PERMIT# 30(1 ©75 <br /> BUILDING i NING • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> El Route to Commercial Building Nonresidential Use <br /> Route to Residential Building Residential Use <br /> El Make this a"We Permit Proposed No.of Dwelling Units: <br /> Bldg/Ti/Addn/Rem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? DYes ONo <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement ElNo DYes, Fin!Unfin School Impact Fee: Total $ <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group R— Z.. ❑Everett School Dist DMukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/112022: <br /> Fire Sprinklers: [Update Existing ONew System ❑Not Req`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: ❑Update Existing ONew System ONot Req`d Permit Technician Use Only:Apply Phase-in Credit Per EMCI9.53.200 <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 No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 dots required prior to final? PYes ❑No ❑ 0%Credit Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$2-7 / 75,dL9 Additional Notes: <br /> Approved By: Date: <br /> PUBLIC WORKS • . . . <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if <br /> [(Sys Dev Eva!(UtiliSVV) ['Traffic Mit Eval <br /> Approved Date:pe/fri/ra ['SiteWork/Drainage ['Address Letter <br /> ['Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT supportive housing) <br /> Separate 1 Deferred Submittals Required: ❑Route this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers OFire Alarm Other: OThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND®Create Green Folder OSubmitted Previously ❑Deferred <br /> • El This Permit is Approved by Public Works <br /> Fire Dept.Fees: El See PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FiRE FEE ❑A Separate PW Permit is Required(Permit#: PW ) <br /> Minimal or No Fire Scope-NO FIRE FEE AND ❑Is located in this folder <br /> ❑ Review!Inspection Scope-ADD FIRE FEE C( is in a Separate Green Folder(join 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 /> ELECT.RICALII?LUMBlNG Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br />