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Intake HpproVa1 meet (1-1)t(t' J iWJ11 b-1Ht-t- ONLY) PERMIT# 67013 -of? <br /> BUILDING • •NNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> ❑ Route to Commercial Building Nonresidential Use <br /> Route to Residential Building Residential Use <br /> ❑Make this a"W"Permit Proposed No.of Dwelling Units: <br /> Bldg/TllAddnlRem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size PIanning/Landscape Inspection Required before Final? QYes DNo <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement DNo C(Yes, Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group DEverett School Dist DMukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/112022: <br /> Fire Sprinklers:❑Update Existing EINew System ❑Not 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: OUpdate Existing ONew System ❑Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EIVICI9.53,200 <br /> Reason Fire Alarm Required: r—� t--( El 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF Worksheet req`d for permit? DYes El No ❑ 50%Credit-Issued 0/3/2022-6/2/2023 <br /> Add'I RCW 64.55 does required prior to final? CIYes CINo ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ er 8(6,dV Additional Notes: <br /> Approved By: Date: <br /> PUBLIC WORK . . . <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PWWorksheetNeeded if <br /> Days Dev Eval(11513w)QTraffic Mit Eval <br /> Approved$ Date: C3k yr,0 5 DSite Work/Drainage ❑Address Letter <br /> 1:1I3ackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> •FIRE DEPARTMENT ' • supportive housing) <br /> Separate/Deferred Submittals Required: EIRoute this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: EIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND OCreate Green Folder OSubmitted Previously ❑Deferred <br /> • 0 This Permit is Approved by Public Works <br /> Fire Dept.Fees: 0 See PW Review Worksheet and associated attached items <br /> Q Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW ) <br /> Ei Minimal or No Fire Scope-NO FIRE FEE AND ❑Is located in this folder <br /> Review/Inspection Scope ADD FIRE FEE 0 Is in a Separate Green Folder(loin with this folder for permitIssuance) <br /> Approved By: & ,n Date: 57,2 --2.3 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> ❑Public Works has no scope--PW Not Required <br /> EL.EGTRICALIPLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: • Date: <br />