1135 CRAFTSMAN WAY PORT OF EVERETT OFFICE 2023-10-23

Intake &Approval Sheet Aik (FOR PERMIT STAFF ONL19 PERMIT# Sc 0 "c9oq ler BUILDING •LANNING E aa(99''/6-6-" Intake OK by: Date: Intake OK bj _ Assign To: Date: Intake Comments: Intake Comments: Zone v 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 ❑Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: ❑ 100%Credit Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total $S 042i 00 Additional Notes: Approved By: Date: / PUBLIC WORKS Additional Notes: Intake OK by: 9 1L2 Date: 112-'21 Z?/ Intake Comments: PW Worksheet Needed if: O ( v OSys Dev Eval ❑Traffic Mit Eval Approved B*421.-4, Date: (f� zZ ed ❑Site Work or Drainage Proposed // / ❑Backflow Prevention for high hazard: Cv/ (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 ❑Fire Sprinklers ❑Fire Alarm DOther: DThis 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: 0 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 0 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) ►4 r ublic Works has no scope---PW Not Required 1 ELECTRICAL/PLUMBING ''dditional Notes: Additional Notes: Approved By: Date: Approved By: Date: