Laserfiche WebLink
Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# g2-404-' 050 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign Toz JA "1 Date: ��l 7.42i. <br /> Intake Comments: Intake Comments: <br /> Zone <br /> ❑ Make this a "W" Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement <br /> Bldg/TI/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct. Size 210 Residential Use S11- — I1€L') deck <br /> Number of Stories ��{{ Proposed No. of Dwelling Units: <br /> Basement l�INo ❑Yes , Fin/Unfin Total No. of Dwelling Units: l 646 c1,144.NJ¢-\J <br /> Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes DNo <br /> Occupancy Group i f2 (� "In Lieu" Fee: Type: Amount$ <br /> Occupancy Load School Impact Fee: Total $ 11 (a <br /> Cert. of Occpuancy Required? KNo ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year ,12021 02018 02015 DEverett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: El Update Existing El New System tifNot Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ ✓t I� (net due after credit for existing uses) <br /> Fire Alarm: El Update Existing El New System SNot Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total $ is ( <br /> IPGF (9E0: X sui = 113,Lig(1l Approved By: Date: 4//2,Z3Z-Lf <br /> Coi S9) <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: IPW Review&Worksheet Needed if: <br /> 1❑Sys Dev Eval : <br /> Additional Notes: ❑Water ❑Sewer ❑Storm <br /> . T "'Al 'f W t ZI1 ('AA `U?J ❑Traffic Mitigation Eval <br /> Approved By:4), D/ -� Date:g rl�L� 74 ❑Site Work/Drainage(shown/triggered) <br /> ❑Address Letter <br /> FIRE DEPARTMENT `❑Backflow Prevention for high hazard: <br /> (dental,Separate/Deferred Submittals Required: hospital,medical,animals,houi mortuary, <br /> p q supportive housing) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: ❑ 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 ❑ Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By: Date: � El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> �y <br /> a't•ablic Works has no scope on this permit--- PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By��� Date:64/Z7)1 .4 <br />