Laserfiche WebLink
Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 1 d2 3 CO -0 q. <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> 0 Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement <br /> Bldg/TI/Addn/Rem Size {J i`e44 Nonresidential Use <br /> Garage/Accessory Struct.Size 0 14/41 Residential Use <br /> Number of Stories ' Proposed No.of Dwelling Units: <br /> Basement £4o ❑Yes , Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction `J T7 Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Occupancy Group )Z--Z "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load !''JO School Impact Fee: Total $ <br /> Cert.of Occpuancy Required? to ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year 02021 p2018 02015 El Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: El Update Existing El New System Ekot Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: <br /> ii Park Impact Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing El New System IL�Not Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 4{ No <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes f6Wo Additional Notes: <br /> VALUATION CALCULATION: Total$ 771 717. if7 <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: IiPW Review&Worksheet Needed if: <br /> (OSys Dev Eval: <br /> hp� _/' 4 __y,_„ I ❑Water OSewer ['Storm <br /> Additional Notes: 'G(/� W'"v'^ 'V•f"'wtYS <br /> i <br /> C(Traffic Mitigation Eval <br /> Approved By: `A`IV/(, _ Date: V&/2 Il OSite Work/Drainage(shown/triggered) <br /> I DAddress Letter <br /> I <br /> FIRE DEPARTMENT 'DBackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary, <br /> Separate/Deferred Submittals Required: <br /> hospital,supportive housing) <br /> ['Fire Sprinklers ❑Fire Alarm ❑Other:_ <br /> Additional Notes: ❑This Permit is Approved by Public Works <br /> . ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Goin 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 on this permit---PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br />