Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 3Z302" OF�P <br /> BUILDING likLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone L 12_ <br /> Overlay/Agreement <br /> ❑ Route to Commercial Building Nonresidential Use y <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? ❑Yes ❑No <br /> Number of Stories "In Lieu"Fee: Type: Amount$ <br /> Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ / <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group 54 ./3 ❑Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: <br /> Fire Sprinklers: PUpdate Existing ❑New System ❑Not Req'd Park Impact Fee Total$ (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: glpdate Existing ONew 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 I.No 0 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 docs required prior to final? Ekes LfNo 0 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$10/ ne,at) Additional Notes: <br /> 1:)11(14 a/24.3 <br /> Approved By: Date: <br /> • PUBLIC WORKS <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if::� <br /> Y1 o *15 Inl y,v J ait ys Dev Eval(Util/SW)L�"1Traffic Mit Eval <br /> Approved B Date: O3 �7v 3 Ak r et ,J/JJ ❑Site Work/Drainage ❑Address Letter <br /> e- ' (/ ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT supportive housing) <br /> Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> W�1 This Permit is Approved by Public Works <br /> Fire Dept.Fees: See PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#:PW <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder <br /> Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Goin with this folder for permit issuance) <br /> Approved By: tr �y. Date: .3-/1p 3 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> "Vi=1 Public Works has no scope---PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: �—/ <br /> Approved By: Date: Completed By: L Date: /Z$/ZeZ., <br />