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Intake u Approval sheet (mixI-". 111V111 •SIAt-I- ONLY) PERMIT# p:,o"Z304�p 7® <br /> BUILDING 0 4rNNING • <br /> Intake OK by: Date: intake OK by: Assign To: Date: <br /> intake Comments: Intake Comments: <br /> Zone I.--2 <br /> Overlay/Agreement <br /> Route to Commercial Building Nonresidential Use <br /> Q Route to Residential Building Residential Use ?� <br /> Make this a"W"Permit Proposed No.of Dwelling Units: <br /> BIdgiTl!Addn/Rem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size PIanning/Landscape Inspection Required before Final? CIYeS i INo <br /> Number of Stories l "In Lieu"Fee:Type: Amount$ <br /> Basement DINo DYes, Fin/Unfin School Impact Fee: Total $ "--- <br /> Type of Construction i(1--C- Calculated: - Credit: <br /> Occupancy Group ,T`(A 0Everett School Dist DMukilteo School Dist <br /> Occupancy Load ' Park Impact Fees for permits applied for after'I1112022: <br /> Fire Sprinklers:QUpdate Existing ONew System .4,Not Req'd Park Impact Fee Total (net due after credit for existing uses) <br /> Reason Sprinklers Required: rq Fee Schedule Used For Calcu ation(Year): <br /> Fire Alarm: Update Existing ONew System tgl�tot Req'd Permit Technician Use Only:Apply Phase-In Credit Per 1~IVIC19.53.200 <br /> Reason Fire Alarm Required: El 100%Credit-issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF worksheet req'd for permit? °Yes RI No 1D 50%Credit-Issued 9/3/2022-.6/2/2023 <br /> Add'!ROW 64.56 dots required prior to final? CIYes 15No C.I 0%Credit-issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ i 1,I®©.®d Additional Notes: <br /> �Or 7 Li/27/2� <br /> Approved By: Date: <br /> pukiG WORKS • <br /> Additional Notes: 5PEC1 - t)J�PF�-IN)As Intake OK by: Date: <br /> Intake Comments; PW Worksheet Needed if: <br /> DSys Day Eva!(UtiI/sW)[(Traffic Mit Eva! <br /> Approved By: A.Qt-P Date: 41211207.3 Mite Work/Drainage [(Address Letter <br /> • Mackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT supportive housing) <br /> Separate!Deferred Submittals Required: DRoute this folder for PW Review at end --PW Review Worksheet <br /> OIFire Sprinklers ❑Fire Alarm DOther: 1..._lThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND 0Create Green Folder ❑Submitted Previously i—lDeferred <br /> • 0 This Permit is Approved by Public Works <br /> Fire Dept.Fees: CI See PW Review Worksheet and associated attached items <br /> CI Review of As-Built Plans-NO FIRE FEE El A Separate PW Permit is Required(Permit#: PW ) <br /> 0 Minimal or No Fire Scope-NO FiRE FEE AND I_( Is located in this folder <br /> 0 Review/Inspection Scope-ADD FIRE FEE CI Is in a Separate Green Folder coin with this folder for permit issuance) <br /> Approved By: Date: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> El Public Works has no scope--PW Not Required <br /> ELECTRICAL/PLUMBING . Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: • Date: <br />