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Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) PERMIT# 132-7-1 ~ I 0 f <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:e Assign To: Jess Date:IU J22/22 <br /> Intake Comments: Intake Comme <br /> Zone <br /> Overlay/Agreement AIA+ACA,Sidewc -'firior\ktj <br /> ❑ Route to Commercial Building Nonresidential Use CIA <br /> ❑ Route to Residential Building Residential Use MU I{;-f ar+n;I, <br /> ❑ Make this a"W" Permit Proposed No.of Dwelling Units: NIA <br /> Bldg/TI/Addn/Rem Size 2-1 n 42' Total No.of Dwelling Units: MLA <br /> Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes .®No <br /> Number of Stories Qj "In Lieu" Fee:Type: Amount$ <br /> Basement ®No ❑Yes , Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction Y 4. Calculated: Credit: <br /> Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: <br /> Fire Sprinklers: ❑Update Existing New System MNot 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: ❑Update Existing ❑New 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? 0Yes 0 No 0 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ 4O,045° Additional Notes: <br /> Approved By Date: I I IZZ 1ZZ <br /> PUBLIC WORKS <br /> Additional Notes: 1 -tt. nk4S. Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval(Util/SW)❑Traffic Mit Eval <br /> Approved By: 0E' Date: a (2o 7 DSite Work/Drainage DAddress Letter <br /> ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT supportive housing) <br /> Separate 1 Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> El 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 /> ❑ 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(join 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---PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br />