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Intake &Approval Sheet •FOR PERMIT STAFF ONLY) PERMIT#B/2-3 0-1—Oil
<br /> BUILDING PLANNING
<br /> Intake OK by: Date: Intake OK by: of Assign To: ,..\e,s5 Date: 7JZCo/23
<br /> Intake Comments: Intake Comments:
<br /> Zone .� - _
<br /> Overlay/Agreement _Al A a 4CA
<br /> ❑ Route to Commercial Building Nonresidential Use Man' 4 Indus g�r assernbti
<br /> ❑ Route to Residential Building Residential Use /U/A
<br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: N//a
<br /> Bldg/TI/Addn/Rem Size NA Total No.of Dwelling Units: N IA
<br /> Garage/Accessory Struct.Size ON Planning/Landscape Inspection Required before Final? ❑Yes ❑No
<br /> Number of Stories , "In Lieu"Fee:Type: Amount$ O
<br /> Basement INo ❑Yes , Fin/Unfin School Impact Fee: Total $0
<br /> Type of Construction 1. Calculated: Credit:
<br /> Occupancy Group offi‘ ❑Everett School Dist ❑Mukilteo School Dist
<br /> Occupancy Load 4/M Park Impact Fees for permits applied for after 1/1/2022:
<br /> Fire Sprinklers: El Update Existing El New System ®Not Req'd Park Impact Fee Total$
<br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year):
<br /> Fire Alarm: CI Update Existing El New System ©Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200
<br /> Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022
<br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No 0 50%Credit-Issued 9/3/2022-6/2/2023
<br /> Add'I RCW 64.55 docs required prior to final? ❑Yes EI No ❑ 0%Credit-Issued 6/3/2023 or later
<br /> VALUATION CALCULATION: Total $ itte/0 Q e Additional Notes:
<br /> Approved By:,-0,6 Date:M(0/23
<br /> PUBLIC WORKS
<br /> Additional Notes: ( i4, Intake OK by: Date,,,,,,,,,,,,,,,,,,,.,,.,..,,,...._......,,.........-..................,...,...,..,.,,.,.,,.,,,,,.,,,,,.,,,,.,.,..,.,,...
<br /> $ r+� t Intake Comments: PW Worksheet Needed if:
<br /> 4tc9 it C o r o iS}3 ❑Sys Dev Eval ©Traffic Mit Eval
<br /> Approved By: `i S w.r,,,,�,,,, Date: 0 ,,,,,-i ,�,? !Mite Work or Drainage Proposed
<br /> r I DBackflow Prevention for high hazard:
<br /> _(dental,medical,animals,mortuary,hospital,
<br /> FIRE DEPARTMENT 'supportive housing)
<br /> I.
<br /> Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet
<br /> ❑Fire Sprinklers ❑Fire Alarm DOther: ❑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 /> El Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance)
<br /> Approved By: K kyz? .t>Kl Date: [J-3-a3 ❑ Will be issued Separately(Separate Green Folder,PW issued ahead of Bldg)
<br /> IttPublic Works has no scope---PW Not Required
<br /> ELECTRICAL/PLUMBING Additional Notes:
<br /> Additional Notes:
<br /> Approved By: Date: Approved By�� (4. Date: 451( .4 It.t
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