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An aKO 6ciipprovai . .neet (rUtCr=1-11V1.11 a1.Hrr WILY) PERMIT# p,�3 0 .. 04 <br /> BUILDING • •ANNING Y <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone A- L <br /> Overlay/Agreement ID 0 AAA 1{'S-1z4`f e Oft;-f 1Y - <br /> Q Route to Commercial Building Nonresidential Use • <br /> E( Route to Residential Building Residential Use S-F 1_ <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: <br /> BIdg/TI/QtRem Size Lt to Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size _ Planning/Landscape Inspection Required before Final? QYes O(No <br /> Number of Stories `l "In Lieu"Fee:Type: Amount$ <br /> Basement 1No C(Yes, Fin/Unfin School Impact Fee: Total $ Vt or'.. ' <br /> Type of Construction 1,12_c, Calculated: Credit: <br /> Occupancy Group ,C. ❑Everett School Dist 1 IMukilteo School Dist <br /> Occupancy Load 524... Park Impact Fees for permits applied for after 1/112022: jti d ii-t - <br /> Fire Sprinklers: OUpdate Existing ONew System KINot 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: ❑Update Existing ®New System I Not Req`d Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 <br /> Reason Fire Alarm Required: El 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 ME worksheet req`d for permit? DYes M.No El 50%Credit-Issued 0/3/2022-6/2/2023 <br /> Add'I ROW 64.55 does required prior to final? CIYes El No El 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ 9O/00o Additional Notes: <br /> Approved By: 4, Date: 7. 2 7. 2-‘22_3 <br /> P•UI3LiC WGRkC <br /> Ad Tonal Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed If:❑Sys Dev Eval(Util/SW)QTraffic Mit Eval <br /> A proved By: G,t4.py��,, Date: c� 1�g 1 Mite Work/Drainage lJAddress Letter <br /> ❑Backflow Prevention for high hazard: <br /> if <br /> - <br /> (dental,medical,animals,mortuary,hospital, <br /> •FIRE I]PPARTIVIPNT supportive housing) <br /> • <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 EICreate Green Folder EISubmifted Previously ElDeferred <br /> This Permit is Approved by Public Works <br /> Fire Dept Fees: N See PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FIRE FEE A-A Separate� PW Permit is Required(Permit it PW 2-30 `7•od8 ) <br /> , / <br /> El Minimal or No Fire Scope-NO FIRE FEE AND Located in this folder <br /> El Review!Inspection Scope-ADD FIRE FEE Q Is in a Separate Green Folder(loin with this folder for permit Issuance) <br /> Approved By: Date: El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> El Public Works has no scope--PW Not Required <br /> EL.BCTRIC.ALIRLUMBING . Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed Date: 8 23 <br />