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Intake&Approval Sheet TOR PERMIT STAFF QNL.IO PERMITL��,I.F 03 _ O W <br /> BUILDING P_ .NiNG <br /> Intake OK by: Date: Intake OK by: Assign To:-V( _ Date. <br /> Intake Comments: intake Comments: <br /> Zone <br /> Make this a"W"Permit ❑SRC Required (Pre-Insp) Overlay/Agreement <br /> Bldg /Addn/ ern Size Z r Nonresidential Use AM.rcJ.c.� <br /> Garage ecessary Struct-Size Residential Use <br /> Number of Stories Z Proposed No.of Dwelling Units: <br /> Basement []No QYes, Fin 1 Unfin Total No.of Dwelling Units: <br /> Typo of Construction PlanninglLandscape Inspection Required before Final? QYes RNo <br /> Occupancy Group i "In Lieu"Fee:Type: Amount$ AJ <br /> Occupancy Load School impact Fee: Total $ W 1 A <br /> Celt, of Occppancy Required? []No a.Yes Mhell Only Calculated: Credit: <br /> Code Year 1112021 V2018 Q2015 QEverett School Dist QMukiltee School Dist <br /> Fire Sprinklers: pdate Existing QNew System QNat Req`d Park:Impact Fees for permits applied for after 11112022. <br /> Reason Sprinklers Required: -e-j (J< O1v Park impact Fee Total� Al 1 A4 (net due after credit forexisfrng uses) <br /> Fire AIarm: pdate Existing QNew System Mot Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: /via✓ <br /> RCW 64.55 MF worksheet req`d for permit? QYes M No <br /> Adel RCW.64.55 does required priorto final? QYes No Additional Notes: <br /> VALUATION CALCULATION: Total, <br /> Approved By: pate: Z A —ch 1-64 <br /> PUBLIC ftfiKS <br /> Intake OK by- Date: <br /> Intake Comments: AW&"V1ew&Worksheef Needed if, W <br /> j L7Sys Dev Evai: <br /> Additional Notes: VaUtL <br /> ?7 ElWater USewer Clstorm <br /> p C ,L 1O L 6 3, _- PA11 f 5. ;l]Trafric Mitigation EvaI, <br /> Approved By: Date: i ClSite Work/Drainage(shown/triggered) <br /> !EJAddress Letter <br /> FikE'DEPARTWNT ;Mackffow Prevention for high hazard. <br /> Separate 1 Deferred Submittals Required: `(dental,medical,animals,mortuary, <br /> hospital,supportive housing) <br /> ire Sprinklers 91FIre Alarm UOther: <br /> Additional Notes: Q This Permit Is Approved by Public Works <br /> Q See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: Q A Separate PW Permit is Required(Permit#:PW ) <br /> Q Review of As-Built Plans-NO FiRE FEE AND Q Is fully digital <br /> Q Minimal or No Fire Scope-NO FIRE FEE Q Is located in this folder <br /> [ Review/Inspection Scope-ADD FIRE FEE Q Is in a Separate Green Folder Qornw;th this fotderfor permit issuance) <br /> Approved BT.V Date: / Q 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 /> E,LE0T.R(CALJPLU1111BING Additional Notes: <br /> Additional Notes: ` <br /> Approved By: Date: Completed By. Date: o:) JZ5 �,t 4 <br />