Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# /2 3 OC"--eVC( <br /> BUILDING • •ANNING "�3O5 <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 /> ❑ Route to Residential Building Residential Use <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: <br /> BIdglTl/Addn/Rem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size Planning/Landscape inspection Required before Final? ❑Yes ❑No <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement ❑No ❑Yes, Fin/Unfin School impact Fee: Total $ <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/112022: <br /> Fire Sprinklers: DUpdate 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: DUpdate Existing ❑New System :Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 <br /> Reason Fire Alarm Required: r1--7( El 100%Credit-issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF Worksheet req'd for permit? DYes 0 No LI 50%Credit-Issued 0/3/2022-6/2/2023 <br /> Add'i RCW 64.55 does required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ 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 Evai(Util/sW)❑Traffic Mit Eva! <br /> Approved By: Date: DSite Work/Drainage )]Address Letter <br /> DBackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT * supportive housing) <br /> Separate I Deferred Submittals Required: DRoute this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> 0 This Permit is Approved by Public Works <br /> Fire Dept.Fees: ❑ 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 0 is located in this folder <br /> Review/inspection Scope ADD FIRE FEE ❑ is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By.,ja(`pw$1 Date: G-9.2 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> ❑Public Works has no scope--PW Not Required <br /> ELECTRICALIRLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br />