Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 6 09 307 ' 00 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: pC. Assign To: Date: 8 Au124)23 <br /> Intake Comments: Intake Comments: <br /> Zone R,I _ <br /> Overlay/Agreement _ <br /> ❑ Route to Commercial Building Nonresidential Use <br /> ❑ Route to Residential Building Residential Use 4FA. _ <br /> ❑ Make this a"W" Permit Proposed No.of Dwelling Units: I <br /> Bld i'TI/Addn/Rem Size f"i3 F h eA-i 5\ Total No. of Dwelling Units: 1 <br /> Garage/Accessory Struct. Size c N? Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Number of Stories 3- "In Lieu"Fee:Type: Amount$ <br /> Basement No ❑Yes , Fin/Unfin School Impact Fee: Total $ (.,2 SI <br /> Type of Construction 79 C Calculated: (v,286 Credit: <br /> Occupancy Group Zgrl. 71Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load (-- Park Impact Fees for permits applied for after 1/1/2022: <br /> Fire Sprinklers: El Update Existing ®New System El Not Req'd Park Impact Fee Total$ 3/ ISO <br /> Reason Sprinklers Required: It+liA/("t, it-V. 7 3,/T7 Fee Schedule Used For Calculation(Year): 1°13 <br /> Fire Alarm: ❑Update Existing 5New System ONot Req'd Permit Technicians:Apply Credit Per EMC19.53.200 <br /> Reason Fire Alarm Required: 117,"^) " } 5.1,14- 7 .5 0 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes I No 0 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 docs required prior to final? oyes L� No El 0%Credit-Issued 6/3/2023 or later <br /> a <br /> VALUATION CALCULATION: Total$ 7 `r, to p t�! Additional Notes: <br /> ''ass - 7F1° 2401C36r ?? <br /> a Z0 4- ' 66 -- 40,71 v Approved By: - " t jv W. Ci.t Date: 6O f�v�usr 26L3 <br /> io3 It- x 66 : 4 ,75� v <br /> PUBLIC WORKS <br /> Additional Notes: itilzlt SAA,ht //tAWaePi. Intake OK by: Date: <br /> 7 JCL ,-/ 1.. �S n t ;�.+ �`�`' Intake Comments: jPW Worksheet Needed if: <br /> " ) I� I DSys Dev Eval ❑Traffic Mit Eval <br /> I <br /> Approved By: Date: 1 .?7/ l/2_ I DSite Work or Drainage Proposed <br /> q iDBackflow Prevention for high hazard: <br /> I(dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT :supportive housing) <br /> I <br /> Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm DOther: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> This Permit is Approved by Public Works <br /> Fire Dept. Fees: QSee PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FIRE FEE FT-A Separate PW Permit is Required (Permit#: PW "2 1301 -oo,3 ) <br /> 0 Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE El Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By:\<, 6-11N,n Date: 7,-,,Z6 g3 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> 0 Public Works has no scope--- PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Approved By: ' % Date: c'7I alio <br />