Laserfiche WebLink
Intake &Approval Sheet *OR PERMIT STAFF ONLY) •ERMIT# ` 1 _ Oc-t 7 <br /> BUILDING PLANNING <br /> Intake OK by: 'K Date: 112)1/2492-ti Intake OK by:_/ Assign To: JeSS Date: I7../23/23 <br /> Intake Comments: tfltil e - C0��05yg� Intake Comore s: <br /> Zone R.-I <br /> CI Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement N/A <br /> Bldg/TI/ /Rem Size `55`6 5 f c,,/t,vt u.N Nonresidential Use N/A <br /> Garage/Accessory Struct.Size _ Residential Use A F I{ <br /> Number of Stories II Proposed No.of Dwelling Units: ti/f <br /> Basement WINO DYes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Constructions Planning/Landscape Inspection Required before Final? DYes E3No <br /> Occupancy Group ,Time "In Lieu"Fee:Type: Amount$ b <br /> Occupancy Load .T ` School Impact Fee: Total $ CU <br /> Cert.of Occpuancy Required? KNo DYes ❑Shell Only Calculated: Credit: <br /> Code Year 02021 R.2018 02015 DEverett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$3', (B 0 (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing El New System SNot Req'd Fee Schedule Used For Calculation(Year): 2.0Z3 <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? DYes Et No <br /> Add'I RCW 64.55 docs required prior to final? DYes EINo Additional Notes: <br /> VALUATION CALCULATION: Total$ 1'/ 6 0 7 <br /> v2"(� it, Approved BY:/€421 ? Date:iZ/Z8/23 <br /> Ff-- FI-PPLic/t -t-enl <br /> PUBLIC WORKS <br /> Intake OK by: 6;1Date: 1,l " 6 J2_ l3 <br /> Intake Comments: PW Review&Worksheet Needed if: <br /> 41 WrA e4. 'V\1,/ ❑Sys Dev Eval: <br /> ►i <br /> Additional Notes: G ' OWater ❑Sewer OStorm <br /> �ry� Cou/t', n/ onn y ^ I� i <br /> ✓W1 IIIlikg,diy <br /> (OTraffic Mitigation Eval <br /> I <br /> Approved By: ,J.. Date: 2./2q/2-4-1 ANAJ IDSite Work/Drainage(shown/triggered) <br /> /AMOK <br /> 1[(Address Letter <br /> FIRE DEPARTMENT DBackflowPreventionforhighhazard: <br /> Separate/Deferred Submittals Required: dh1/(1 • (dental,medical,animals,mortuary, <br /> UU hospital,supportive housing) <br /> ❑Fire Sprinklers ❑Fire Alarm DOther: <br /> Additional Notes: 0 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 0 Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Gain 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 on this permit---PW Not Required <br /> • ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: ` <br /> Approved By: Date: Completed By:AAu(rJ VI Date: \( 2t 12,2.P-, <br />