Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1`1 01 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:J Assign To:J e SS Date: 15/2!4 <br /> Intake Comments: Intake Comments: <br /> Zone B <br /> Overlay/Agreement Cor+hec}oma s4ree� cies %na}lon <br /> ❑ Route to Commercial Building Nonresidential Use G4e}ql1 sal es &se \1 ices <br /> ❑ Route to Residential Building Residential Use tAA <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: N/A <br /> Bldg/TI/Addn/Rem Size Total No.of Dwelling Units: N/A <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes ®No <br /> Number of Stories "In Lieu"Fee:Type: Amount$0 <br /> Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ 0 <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 1/1/2022: <br /> Fire Sprinklers: El Update Existing ❑New System El Not Req'd Park Impact Fee Total$ 0 <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: ❑Update Existing ❑New System El Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 <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 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$A70 o'O0, 00 Additional Notes: <br /> Approved By: - Date:5/Z14 3 <br /> PUBLIC WORKS <br /> Additional Notes: Intake OK by: Date: _ <br /> Intake Comments: PW Worksheet Needed if. <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> Approved Date:L/,S' �6 Z07IJ I[]Site Work or Drainage Proposed <br /> []Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENTsup€ portive housing) <br /> Separate/Deferred Submittals Required: El Route 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 /> ❑ 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 ❑ Is located in this folder <br /> ❑ <br /> Review/Inspection Scope-ADD FIRE FEE ❑ 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 /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />