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Intake &ApprovalFir Sheet (le PERMIT STAFF ONLY) P # & 1'Oc — 065—
<br /> BUILDING PLANNING
<br /> intake OK by: Date: Intake OK by: Assign To: Date: 03/O"4,224
<br /> intake Comments: Intake Comments:
<br /> Zone i 3 • .
<br /> ❑Make this a"W"Permit 0 SRC Required(Pre-Insp) Overlay/Agreement Cam,—s,,iy-e,.•
<br /> Bldg/TllAddn/Rem Size i Nonresidential Use M,Ps
<br /> Garage/Accessory Struct.Size Residential Use !Aoki)?Ve,—fra,ri1.1�w-t� x5 4i,r
<br /> Number of Stories 3 Proposed No.of Dwelling Units: .Pt CJJ .
<br /> Basement NNo DYes, Fin/Unfin Total No.of Dwelling Units: 515 Kr hew Warts
<br /> Type of Construction emu$ Planning/Landscape Inspection Required before Final? ❑Yes 2-No
<br /> Occupancy Group ( .a, • "in Lieu"Fee:Type: t25 Amount$ Co
<br /> Occupancy Load School Impact Fee: Total $,_
<br /> Cert.of Occppancy Required? IIo CIYes ❑Shell Only Calculated: S..7 Credit: 7
<br /> Code Year 02021 E12018 E12015 ElEverett School Dist EIMukllten School Dist
<br /> Fire Sprinklers:OUpdate Existing I—INew System jNot Req'd Park Impact Fees for permits applied for after 11112022:
<br /> -- Reason Sprinklers Required: Park impact Fee Total$ '25 (net due after credit for existing uses) •
<br /> Fire Alarm: QUpdate Existing❑New System f3Not Req'd Fee Schedule Used For Calculation(Year): 05n—n1My1n .,.,,,,,,,,,,,,,,,,,-,,.,,..,,,.,.,,,,.,,.,,.,,,,,,,,.,.,,,.,,,,,,
<br /> Reason Fire Alarm Required:
<br /> RCW 64.55 MF worksheet req'd for perrrift? Dyes itu No ,
<br /> Add'l RCW.64.55 does required prior to final? IIYes ViNo Additional Notes:
<br /> VALUATION CALCULATION: Total$ ,..0 i Q e b
<br /> . Approved By: Date: 63/0,q L2cg u
<br /> PUBLIC WORKS
<br /> Intake OK by: Date:
<br /> • Intake Comments: IPWReviear&WorksheetNeeded if:
<br /> • 1 C(Sys Dev Eval:
<br /> Additional Notes: nn ❑Water DSewer DStorm
<br /> v"1j4IL EQKii ;DTraf is Mitigation Eval
<br /> Approved By: G,g 02•, , Date: 14 (aA IElsite Work/Drainage(shown/triggered)
<br /> • jflAddress Letter
<br /> FAZE DEPARTM.NT Daackflow Prevention for high hazard:
<br /> •
<br /> Separate 1 Deferred Submittals Required: '(dental,hpl medical,r animals,mortuary,
<br /> hospital,supportive housing)
<br /> OFire Sprinklers ❑Fire Alarm ❑Other: .
<br /> Additional Notes: . El This Permit is Approved by Public Works •
<br /> . ❑See PW Review Worksheet and associated attached items
<br /> Fire Dept.Fees: 0 A Separate PW Permit is Required(Permit#:PW ) •
<br /> El Review of As-Built Plans-NO FiRE FEE AND ❑Is fully digital
<br /> Ij Minimal or No Fire Scope-NO FIRE FEE b Is located in this folder
<br /> O Review/Inspection� Scope-ADD FIRE FEE El Is in a Separate Green Folder(join with this folder for permit issuance)
<br /> Approved By; 1p� �m Date:3-i3 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg)
<br /> blic Works has.no scope on this permit---PW Not Required
<br /> . E,LEGTRICAL/PLUMBING dditional Notes:
<br /> Additional Notes:
<br /> Approved By; Date: Completed By. ` Date: OZ1/$t�/let4
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