Laserfiche WebLink
Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# � 6 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: _ Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> ❑Make this a"W"Permit ❑ SRC Required (Pre-lnsp) Overlay/Agreement <br /> Bldg/Tl/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct.Size , Residential Use <br /> Number of Stories Proposed No.of Dwelling Units: <br /> Basement ONo ❑Yes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction Planning/Landscape Inspection Required before Final? DYes ❑No <br /> Occupancy Group "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cert.of Occpuancy Required? No DYes ❑Shell Only Calculated: Credit: <br /> Code Year E2021 02018. 02015 ['Everett School Dist DMukilteo School Dist <br /> Fire Sprinklers: ['Update Existing Mew System @Not Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: DUpdate Existing ONew System @Not Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? DYes No <br /> Add'I RCW 64.55 does required prior to final? ❑l/fY�es KINo Additional Notes: <br /> VALUATION CALCULATION: Total$ y-b/ 64 r 09 <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Review&Worksheet Needed if <br /> IDSys Dev Eval: <br /> ❑Water DSewer ❑Storm <br /> Additional Notes: <br /> I DTraffic Mitigation Eval <br /> Approved By: eick0,,,_,a, Date: 6/7.. j I CDSite Work/Drainage(shown/triggered) <br /> IDAddress Letter <br /> FIRE DEPARTMENT IDBackflow Prevention for high hazard: <br /> Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, <br /> hospital,supportive housing) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: ❑This Permit is Approved by Public Work <br /> ❑See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: 0 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 /> 0 Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder(loin 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: Date: <br />