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Intake &Approval Sheet 'FOR PERMIT STAFF ONt <br /> PERMIT# - .— (j� <br /> BUILDING . 'ANNING <br /> Intake OK by: Date: Intake OK b . <br /> Intake Comments: Y' Assign To: Date: <br /> Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> ElRoute to Commercial Building Nonresidential Use <br /> ❑ Route to Residential Building Residential Use <br /> ❑ Make this a"W"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? <br /> ❑Yes ❑No <br /> Number of Stories <br /> "[n Lieu"Fee: Type; Amount$ <br /> Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction Calculated: <br /> 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: ❑Update Existing ❑New System ❑Not Req'd Park Impact Fee Total (net due affer credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> ----- ------- -------------- ---------------- __ <br /> Fire Alarm: Update Existing ❑New System ❑Not Req'd Permit- Technician Use Only:Apply Phase-In Credit Per EMC19.53.200----------- <br /> Reason Fire Alarm Required: 0 100%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'l RCW 64.55 does required prior to final? ❑Yes ❑No 0 0%Credit-Issued 61312023 or later <br /> VALUATION CALCULATION: Total$ Additional Notes: <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Additional Notes: Intake OK by: Date: <br /> -----------------------d--i-f. <br /> Intake Comments: PW Worksheet Neede ------------- <br /> • <br /> --- <br /> I El Sys Dev Eva[(Utiusvv)❑Traffic Mit Eval <br /> Approved By' Date: ;❑Site Work/Drainage ❑Address Letter <br /> ❑Backf[ow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT ;supporfivehousing) <br /> '---------------------- -- ------Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end ---PWReview 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 /> Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) <br /> Approved By Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of 9ldg) <br /> ❑ Public Works has no scope--PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br /> 2/7,, <br />