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Intake &Approval Sheet ( OR PERMIT STAFF ONLY) PURMIT# <br /> 13UILIIING I PLANNING <br /> intake qK by: Date: Hpr <br /> intake OK by: Assign To: Date., <br /> Intake Comments: Intake Comments: <br /> zone <br /> ❑Make this a"W"Permit ❑SRC RequiredOverlaylAgreement <br /> BIdgrrl/Addn1Rem Size rNonresidential Use <br /> GarageiAccessory Struct.SizeResidential Use <br /> Number of Stories Proposed No,of Dwelling Units: <br /> Basement MNo CTotal No,of Dwelling Units; <br /> Type of Construction '� Planningll:andscape Inspection required before Final? UYes CINo <br /> Occupancy Group "In Lieu"Fee:Typs: Amount$ <br /> Occupancy Load School Impact Fee; Total $ ' <br /> Gott.of Occppancy Required? INNo aYes r_1Shell Only Calculated: Credlt: <br /> Code Year Q2021 02018 020115 DEverett School Dist ElMukllteo School Dist <br /> Fire Sprinklers:Dupdate Existing Maw System 1l❑t Raq'd Park Impact Fees for permits applied for after 11112022, <br /> Reason Sprinklers Required: �q Palk Impact Fee Total,$ (net due after credit rorexlsting uses) <br /> Fire Alarm: Update Existing❑New System WNot Req'd Fee Schedule Used For Calculation(Year): �.V...... �- <br /> Reason Fire Alarm Required: <br /> ROW 64.85 MF worksheetreq'dforpenrilt? UYes El No <br /> Addl RCW.64.58 dons required prior to final? L]Yes BNo Additional Notes: <br /> VALUATION CALCULATJON: Total$ SJ- 2 <br /> Approved By: Date: <br /> PUf3.LIC Wl 0RK8 <br /> intake OK by: Date:1 : <br /> Intake Comments: PWKeviety&WorlfsheetNeededir. <br /> r l_l8ys Dev Eval: _ <br /> Additional Notes: <br /> ElWater bSewer 11stotm <br /> ^ <br /> ElTraffic Mitigation Eva[, <br /> 1 <br /> Approved By: C� Date: 1 Ukk 1USlte WoWDrainage(shovin/triggered) <br /> ElAddress Letter <br /> I;IR) 'p1 PAI�TM NT aBacktiow Prevention for high hazard: <br /> Required: (dental,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Re <br /> q ihaspital,supportive housing) <br /> 1IFire Sprinklers ❑Firo Alarm aOther: i <br /> Additional Notes: This Permit Is Approved by Public Works <br /> d See PW Review Worksheet and associated attached Items <br /> Fire Dept,Fees: A Separate PW Permit Is Requlred(Permit#:PW ) <br /> •Review of As-Built Plans-NO FIRE FED AND p is fully digital <br /> •Minimal or No Fire Scope•-NO FIRE FEE a Is located in this folder <br /> El Review/Inspection Scope-ADD FIRE FEE � Is in a Separate Green Folder qorn*wththrsfolderrorpermltIssuance) <br /> Approved 13,y: Date: a Will be Issued separately(separate Breen}raider,PW issued ahead of6idg) <br /> p Public Works has-no scope on this permit-••PW Not Required <br /> ) EGTR(CAL1P.LUM)3INC Additional Notes: <br /> Additional Notes: ` <br /> Approved By: Date: Completed By. pate: <br />