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Intake&ApprovaI Sheet (FOR PERMIT STAFF OJVLN9 PERMIT# <br /> BUILDING P�,�NN1NG <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> 13 Make this a"W"Permit ❑SRC Required(Pre-lnsp) Overlay/Agreement <br /> 13141TI/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct-Sizell Residential Use <br /> Number of Stories Proposed No.of Dwelling Units: <br /> Basement Mo OYes, Fin I Unfin Total No.of Dwelling Units: <br /> Type of Construction PlanninglLLandscape Inspection Required before Final? QYes []No <br /> Occupancy Croup - "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cert.of Occppancy Required? &o dYes ❑Shell Only Calculated: Credit: <br /> Code Year N2021 C12018 02-m QEverett School Dist ElMukilteo School Dist <br /> Fire Sprinklers:91Update Existing EINew System [hot Req'd Park Impact Fees for permits applied for after 11112022: <br /> Reason Sprinklers Required: Park Impact Fee Total S (net due after credit for exlsffng uses) <br /> Fire Alarm: IK Update Existing ElNew System ❑Not Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> ROW 64.55 MF worksheet req'd for permit? QYes ZI No <br /> Addl RCW.64.55 docs required priorto final? IIYes R[No Additional Notes: <br /> VA:LLA'rION CALCULATION: Total$ C9 <br /> Approved By: Date: <br /> -JAW noo Yg ��tC�lcat� <br /> PUB.LIGWQRKS <br /> Intake OK by: Date: <br /> Intake Comments: pWReview&WorksheetNeededif, <br /> �QSys Dev Eva[: <br /> Additional Notes: I ❑Water USewer ClStorm <br /> IQTrafFc Mitigation Eval, <br /> Approved B Date: G QSite WorldDrainage(shownftdggered) <br /> bAddress Letter <br /> 1 1t�E DE1'APTM>`=1VT` ElBackffow Prevention for high hazard: <br /> '(dental,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Required: hospital,supportive housing) <br /> }Fire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: Q 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 Q Is fully digital <br /> Minimal or No Fire Scope-NO FIRE FEE ❑Is located In this folder <br /> Review/Inspection Scope-ADD FIRE FEE CI Is in a Separate Green Folder QornwiththrsfolderforpermltIssuance) <br /> Approved By: u/Y1 Date —� ; Will be issued separately(separate Green Folder,PW issued ahead of Bldg) <br /> p Public Works has.no scope on this permit---PW Not Required <br /> Ei-M-TRICALI'PLU1111BING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Complefed By: Date: <br />