1401 MERRILL CREEK PKY #5 2024-06-12

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# g0.1,3 '-O BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required(Pre-lnsp) Overlay/Agreement Bldg/TI/Addn/Rem Size DN1 Nonresidential Use Garage/Accessory Struct.Size D G) , Residential Use Number of Stories Proposed No.of Dwelling Units: Basement ONo ❑Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes ❑No Occupancy Group k—y "In Lieu"Fee:Type: Amount$ Occupancy Load �r'' /�' School Impact Fee: Total $ 1 Cert.of Occpuancy Required? L7nvo ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 I2018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ONew System RINot Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: ❑Update Existing El New System mNot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes t4 No Add!RCW 64.55 docs required prior to final? �,�D��Yes �No Additional Notes: VALUATION CALCULATION: Total$ I I 'PI .0 2- Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: IPWReview&Worksheet Needed if: ❑Sys Dev Eval: Additional Notes: ,yid Wi�� h %�► ❑Water OSewer El Storm / ❑Traffic Mitigation Eval Approved By: (4 ,L..� Date: 1�,,6 /Z� OSite Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,por animals,mortuary, p q hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: ❑This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ 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) ❑ Public Works has no scope on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: