Laserfiche WebLink
Intake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# (2- k03—1 :22- <br /> BUILDING • . TONING <br /> intake OK by: Date: Intake OK by: Assign To:�mes'T'`Date: (1)24411 <br /> Intake Comments: intake Comments: <br /> Zone /u <br /> En Make this a"W"Permit ❑SRC Required(Pre-Inup) Overlay/Agreement . <br /> Bid ddn/Rem Size g$ T Nonresidential Use 5 ,Ge_ (.0.1d6‘7.) <br /> Gara a/Accessory Stud.Size �� ,k Residential Use <br /> Number of Stories r0^'v``n Proposed No.of Dwelling Units: . . <br /> Basement Nc [(Yes, Fin/Unfin Total No.of Dwelling Units: ' <br /> Type of Construction ker VA- Planning/Landscape Inspection Required before Final? DYes RtNo <br /> Occupancy Group • "In Lieu"Fee:Type: II /a. Amount$ <br /> Occupancy Load 7 School Impact Fee; Total $ f/4 . <br /> Cert.of Occppancy Required? DNo IYes CDShell Only Calculated: Credit <br /> Cade Year Y12021 ,I2018 02015 DEverett School Dist DMukilteo School Dist <br /> Fire Sprinklers:KUpdate Existing ElNew System !-ONot Req'd Park Impact Fees for permits applied for after 1/112022: <br /> -• Reason Sprinklers Required; f 'Uv row- Park impact Fee Total$ ® (net due after credit far existing uses) • <br /> Fire Alarm: r&pdate Existing❑New System IJNot Req'd Fee Schedule Used For Calculation(Year):MI - ..,-^n Y pn1mannn Wr a.„nuN^„.,..,,,,..,- .,,, <br /> 1 Reason Fire Alarm Required: (iUU <br /> RCW 64.55 MF worksheet req'd for perrriit? DYes No . <br /> Add'I ROW.64.55 does required prior to final? Eyes No Additional Notes: • <br /> VALUATION CALCULATION: Total$ • . <br /> Approved By: abz. 4C�,.,.:_ 7 Date: k'z <br /> . PUB;LICWORKS ' <br /> Intake OK by: Date: <br /> Intake Comments: • IPWReview&Worksheet Needed if: <br /> I 1 Ejsys Dev Eva!: <br /> Additional Notes:A (^' L 161 • { DWater �ISewer ClStorm <br /> QTraffc Mitigation Eva!, <br /> S <br /> Approved By: {IL�� Date: 4(V/ ilJSite Work/Drainage(shown/triggered). _ (� 1DAddress Letter <br /> FIRI~'Dl~PARTMO1VT `i-lBackflow Prevention for high hazard: <br /> (denial,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Required:q Ihospital,supportive housing) <br /> Fire Sprinklers EIFire Alarm :lather: I <br /> Additional Notes: . El This Permit Is Approved by Public Works ' <br /> El See PW Review Worksheet and associated attached items <br /> . . Fire Dept.Fees: El A Separate PW Permit is Required(Permit#:PW ) • <br /> Eyy Review of As-Built Plans.NO FIRE FEE AND 0 Is fully digital <br /> —Minimal or No Fire Scope-NO FIRE FEE a Is located in this folder <br /> El Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder(fern with this folderfor permit Issuance) <br /> Approved By: Gti c Date: ji-a,^2,2' El Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> ' Public Works has•no scope on this permit---PW Not Required <br /> • ELEGTWICAL/PLUMBING • Additional Notes: _ <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: 0/111 <br />