Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Yp'' 0 'C5' <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Jess Date: 10 /I 7 f 2.3 <br /> Intake Comments: Intake Comments: <br /> Zone Si Ciusirtess <br /> ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement C0rv"eG't'ar SNreege. <br /> Bidg/TI/Addn/Rem Size Nonresidential Use FOesralotMe;en+ <br /> Garage/Accessory Struct.Size Residential Use N/A <br /> Number of Stories Proposed No.of Dwelling Units: >S/A <br /> Basement INo ❑Yes, Fin/Unfin Total No.of Dwelling Units: N/A <br /> Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes RINo <br /> Occupancy Group "In Lieu"Fee:Type: Amount$ 0 <br /> Occupancy Load School Impact Fee: Total $ 0 <br /> Cert.of Occpuancy Required? Ilo ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year 02021 ®2018 02015 El Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing ❑New System rifiNot Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ 0 (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing ❑New System vg'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 J No <br /> Add'l RCW 64.55 docs required prior to final? ❑Yes la No Additional Notes: <br /> VALUATION CALCULATION: Total$ '0'/11"41. c <br /> co Approved By:� as/ Date: 10/I'7/2 3 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Review&Worksheet Needed if: <br /> ❑Sys Dev Eval: <br /> Additional Notes: ❑Water ❑Sewer ❑Storm <br /> t�C/r OTraffic Mitigation Eval <br /> Approved By: ( Date: Uel.r I'' /,23- Mite Work/Drainage(shown/triggered) <br /> I❑Address Letter <br /> FIRE DEPARTMENT j❑Backflow Prevention for high hazard: <br /> Separate/Deferred Submittals Required: thospitl,medical,pr animals,mortuary, <br /> �hospitai,supportive housing) <br /> El Fire Sprinklers ❑Fire Alarm DOther: <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: (-0 W, N Date: —I 2 3 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Rublic 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: /�I�r3 /toz-3 <br />