3003 W CASINO RD BLDG 40-202 2023-12-06

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 61- 3D,s—'007 BUILDING • 1 •ANNING 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/TllAddn/Rem Size Total No.of Dwelling Units: Garage/Accessory Struct.Size PIanning/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 DEverett 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$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technician Use Only:Apply Phase-in Credit Per EMC19.53.200 Reason Fire Alarm Required: El 100%Credit-issued 1/1/2022-9/2/2022 ROW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add!ROW 64.55 does required prior to final? ❑Yes ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: Approved By: Date: male WORKS . Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval Approved By: Date:. ❑Site Work/Drainage DAddress Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, •FIRE DEPARTMENT supportive housing) Separate!Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑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:•K, `�` Jy\ Date: lf.-6 2 3 ❑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: