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Intake &Approval Sheet OFOR PERMIT STAFF ONLY) • RMlT# BC2 q Q -0 <br /> BUILDING . PLANNING <br /> intake OK by: Date: Intake OK by: Assign To: j,(1d.� Date: 3/4f21 <br /> intake Comments: Intake Comments: <br /> Zone L,i z . <br /> ❑Make this a"W"Permit ❑SRC Required(Pre-insp) Overlay/Agreement • A/A I SW Evan{ Qe,wle P,(d <br /> Bldg/Tl/Addn/Rem Size /VP Nonresidential Use ye <br /> Garage/Accessory Struct.Size AJi Residential Use <br /> Number of Stories / • Proposed No.of Dwelling Units: b <br /> Basement Jlo 0Yes, Fin/Unfin Total No.of Dwelling Units: 0 ' <br /> Type of Construction 1/ -8 PlanninglLandscape Inspection Required before Final? ['Yes E Io • <br /> Occupancy Group 13, F-L. S-Z "in Lieu"Fee:Type: Amount$ <br /> Occupancy Load ' I School impact Fee: Total $ <br /> Cert.of Occpuancy Required? giNo 0Yes ['Shell Only Calculated: l Credit: <br /> Code Year 02021 FR018 02015 ['Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers:grUpdate Existing ONew System ONot 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: 14,Update Existing El New System ONot Req'd Fee Schedule Used For C culation(Year)o loMIIIIIMI/M.11.1111111.11I00.1111•111.1..01/331101aMMI.M•111.11.1M11.1111.11.114.1.14111011^^„MX11.1.11.11111.111.111 <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for perrrilt? DYes x,No <br /> Add'I RCW 64.55 docs required prior to final? DYes yrsallo Additional Notes: V‘K(to r Scott. c AL1 % wO c +,n USA, <br /> VALUATION CALCULATION: Total$ yo,a9a II <br /> Approved By: —7./4// l' Date: Q 11/3 LI <br /> PUBLIC WORKS . <br /> Intake OK by: Date: <br /> Intake Comments: In/Review&WorksheetNeeded it: <br /> w <br /> • IOSys Dev Eval: <br /> Additional • <br /> Notes: (( ❑Water bSewer f�5torm <br /> / (Traffic Mitigation Eva! <br /> Approved B !l n/i Date: /6/2 y !Mite Work/Drainage(shown/triggered). b JJJ Address Letter <br /> FlRRJ~DEPARTMENT ;DBackflow Prevention for high hazard: <br /> • <br /> {`{dental,medical,animals,mortuary, <br /> Separate/Deferred Submittals Required: <br /> !hospital,supportive housing) <br /> OFire Sprinklers ['Fire Alarm ❑Other: t . <br /> I <br /> Additional Notes: Q This Permit is Approved by Public Works • <br /> . 0 See PW Review Worksheet and associated attached items <br /> Fire Dept,Fees: 0 A Separate PW Permit is Required(Permit#:PW ) • <br /> El Review of As-Built Plans-NO FIRE FEE AND ❑Is fully digital <br /> 0 Minimal or No Fire Scope-NO FIRE FEE Cl Is located in this folder <br /> I Review!Inspection Scope_ADD FiRE FEE 0 Is in a Separate Green Folder(iotn with this t'olderforpermlt issuance) <br /> Approved By: ,ATc,c4.2y) Date: .',�� .5/ El 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 dditional Notes: <br /> Additional Notes: ` <br /> Approved By: Date: Completed By: Date: 747,0/ <br />