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intake &Approval Sheet (FOR PERMIT STAFF ONLY PERMIT <br /> BUILDING PLANNING <br /> Intake OK by: Date: intake OK by: Assign To: bate: <br /> intake Comments: Intake Comments: <br /> zone <br /> ❑Make this a"W"PerrSRCed(Pre-Insp) OverlaylAgreementBldg/TI/Addn/Rem SizeNonresidential UseGarage/Accessory StruResidential UseNumber of StoriesProposed No.of Dwelling Units: <br /> Basement , Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction Planningll.andscape Inspection Required before Final? oyes ONO <br /> Occupancy Group "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cert.of Ocepuancy Required? []No ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year ❑2021 ❑2018 ❑201b []Everett School Dist ❑Mukllteo School Dist <br /> Fire Sprinklers, ❑Update Existing[]New System ❑Not Req'd Park impact Fees for permits applied for after 11112022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for exlsting uses) <br /> Fire Alarm: Update Existing❑New,System Not Req'd Fee Schedule Used For Calculation(Year): <br /> � ,� -r <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for perrriit? []Yes ®No <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes []No, Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> j Approved By: Date: <br /> PUI LIG WORKS <br /> Intake OK by: Date:_ __ <br /> Intake Comments: PW Review&Worksheet Needed 1f <br /> (]Sys De <br /> v Eval <br /> ClWater Mewer ❑storm <br /> Additional Notes: <br /> • II]Traffic Mitigation Eval <br /> Approved By. Date' 'Elsite Work/Drainage(shown/triggered) <br /> ❑Address Letter <br /> FIRE DEpARTMJ~NT ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Required: 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(Permitt PW ) <br /> ❑Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital <br /> Minlmal 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 Qornvrith[his forderforpermltIssuance) <br /> Approved By: 121.1ate: ❑Will he issued separately(separate Green Forder,PW issued ahead of Bldg) <br /> ❑Public Works has-no scope on this permit---PW Not Required <br /> FLEOTR(CAL/Pl-MING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: lComploted By: Date: <br />