Laserfiche WebLink
Intake &Approval Sheet ',(FOR PERMIT STAFF ONLY) •PERMIT#6 QS'Vi-c <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To:.,J•'It-train Date: OH 2l <br /> Intake Comments: Intake Comments: <br /> Zone 'Z—--------+ <br /> PitMake this a"W"Permit kiSRC Required (Pre-Insp) Overlay/Agreement <br /> Bldglfl/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct.Size , Residential Use S- � <br /> Number of Stories r Proposed No.of Dwelling Units: <br /> Basement 13f-No ❑Yes, Fin/Unfin Total No.of Dwelling Units: C. IQJ 1-- 4$ if ii <br /> Type of Construction ( QC- Planning/Landscape Inspection Required before Final? oyes pNo <br /> Occupancy Group 1 -C "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load \ Y--C School Impact Fee: Total $ O <br /> Cert.of Occpuancy Required? kNo ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year l2021 02018. 02015 El Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: ['Update Existing ❑New System 4Not Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ 0 (net due after credit for existing uses) <br /> Fire Alarm: ['Update Existing ❑New System YjNot Req'd . Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes Ea No <br /> Addi RCW 64.55 docs required prior to final? ❑Yes JNo Additional Notes: <br /> VALUATION CALCULATION: Total$ /Or v oo Per Co n,12e✓ <br /> Approved By: A E A Co r TV Date: 6/27/74- <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: frwRevfew&worksheet Needed it:,.,-, .,... <br /> =CISys Dev Eval: <br /> Ad Mil <br /> ( `�j L gi ❑Water ❑Sewer ❑Storm <br /> Additional Notes: <br /> n , ,l�� �44/4 r IDTraffic Mitigation Eval <br /> Approved B : Date: `�/io/Zci (/� �f� DSite Work/Drainage(shown/triggered) <br /> l may errjf (1y .?©r r 'jLAddress Letter <br /> FIRE DEPARTMENT ( e fae-.� OBackflow Prevention for high hazard: <br /> i(dental,(#7(5. medical,animals,mortuary, <br /> Separate/Deferred Submittals Required: p!�_7/fk f. � l,supportive housing) <br /> Ih0ta <br /> Additional Notes: ❑This Permit is Approved by Public Works <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 0 Is located in this folder <br /> 0 Review/Inspection Scope-ADD FIRE FEE CI Is in a Separate Green Folder(join with this folder for permit issuance) <br /> \[Approved By: 4 (h,,'` ' /Date: �r.i�J,- / 0 Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> 1 ` "`^ Public Works has no scope on this permit---PW Not Required <br /> • <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Lh1044 /(_ Date: t ( ?'t I !N <br />