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itiiw a 64 Approval �nee1 (rUt' r.artivt!i II-t t" WILY) FERMI.I g cz 3.0 9 <br /> I3UILI]INGNNING <br /> Intake OK by: Date: intake OK by;it Assign To: c\2$5 Date: 5/3 IZ 3 <br /> Intake Comments: Intake Commenfs: <br /> Zone U R3 <br /> Overlay/Agreement rl/A <br /> ❑ Route to Commercial Building Nonresidential Use IJ/A <br /> ❑Route to Residential Building Residential Use Mobile snow e. Par C. <br /> El Make this a"IN Permit Proposed No.of Dwelling Units; 10 (replace. e,cl,s'ir9) <br /> Bldg/TllAddn/Rem Size 1'-1.i41{- - 4-" Total No.of Dwelling Units: I _ <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? QYes IRtNo <br /> Number of Stories ( In Lieu"Fee:Type: Amount$ ci <br /> Basement lNo ❑Yes, Fin l Unfin School Impact Fee: Total $ C <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group DEverett School Dist DMukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 11112022: <br /> Fire Sprinklers:DUpdate Existing:blew System INot Req`d Park Impact Fee Total$ C (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: ElUpdate Existing ONew System INot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 <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? CIYes I( No El 50%Credit-Issued 9/3/2022-6/2J2023 <br /> Add'l RCW 64.55 dons required prior to final? QYes DZINIo El 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ i c \, Additional Notes:()1/41 i\1 review once SvpP‘erne M-a\ <br /> 'tno 1S recewea see a ctclr,r,e-,+s <br /> Approved By: Tale:55/7Z/Z3 <br /> • PUBL iC WORk's • • • ' <br /> Additional Notes: rZ 44 Lai a rnp,vufruc_-Tr_,ike,> Intake OK by: Date: <br /> Fir- etE, ��i rr„� 4-c. ,1um.e Intake Comments; PWWorksheetNeededlf• <br /> crxnate yorr`m Slip Sliprerea a — ElSys Day Eval(Util/sW)I:Traffic Mit Eval <br /> Approved By: Date: e‘ )/co Mite Work/Drainage ElAddress Letter <br /> 1 / ClBackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> D TMENT supportive housing) <br /> 'FIRE EPAR PP <br /> Separate/Deferred Submittals Required: EIRoute this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers ElFire Alarm Other: DIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND 0Create Green Folder OSubmitted Previously QDeferred <br /> 14 This Permit is Approved by Public Works <br /> Fire Dept.Fees: 0 See PW Review Worksheet and associated attached items <br /> ❑Review of As-Built Plans-NO FIRE FEE 0 A Separate PW Permit is Required(Permit#: PW ) <br /> Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder <br /> El Review/Inspection Scope-ADD FIRE FEE El is in a Separate Green Folder(join With this folderfor permit issuance) <br /> �`�Approved By: ju j Date:5:23--n Cl <br /> 2 3 Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> El Public Works has no scope--PW Not Required <br /> EL.ECT.RICAURLUMBING Additiopal,,Notes,,: np,� i i �pthp /04 <br /> Additional Notes: N T T!N "w�%�C���)�y� '�nw l '_ " �ili <br /> Approved By: Date: Completed By: Date: CJ''')']{)0' <br />