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Intake&,Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �' �qo <br /> 13UILDING PLANNING <br /> intake OK by: page: Intake OK by: Assign To: UK+)h Bate: i ZL( <br /> Intake Comments: Intake Comments; <br /> Zone <br /> ❑Make thin a"W"Permit ❑SRC Required(Pre-Ina ) Overlay/Agreement <br /> 131d I/A�ddnlRem Size Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use <br /> Number of Stories Proposed No,of Dwelling Units: <br /> i3asement PNo ayes, Fin 1 Unfin Total No.of Dwelling Units: <br /> Type of Construction 3 PlanninglLandscape Inspection Required before Final? C(Yes No <br /> Occupancy Group A -2, "In Lieu"Fee:Typo: Amount$ <br /> Occupancy Load Zv School Impact Fee: Total $ <br /> Ceti,of Occppancy Required? allo [ Wes bShell Only Calculated: Credit: <br /> Code Year IW2021 [12018 F 12016 ElEverett School Dist ElMukilteo School Dist <br /> Fire Sprinklers:0Update Existing CINew System F2N,t Req'd Park Impact Fees for permits applied for after 11112022: <br /> Reason Sprinklers Required: Park impact Fee Total _ (net due after credit rorexlsting uses) <br /> Fire Alarm: ElUpdate Existing❑New System UNot Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: � , `wd s to fr,li µovv serve CR� <br /> RCW 64.66 MF worksheet req'd for pernilt? UYes No r <br /> Add'I RCW.64.68 docs required prior to final? ElYes WNo Additional Notes) <br /> V=ATION GALCULATJON: Total$ <br /> Approved By: Date: <br /> PUf.LIC WORKS <br /> intake OK by: pate: <br /> Intake Comments: PWKeview&Worksheef Needed if <br /> ClSys Dev Eval: <br /> Additional Notes: UWater E bawer Elstonn <br /> EQTraffic Mitigation EvaL <br /> Approved By. Date: FIStte WorklDrainage(shown/triggered) <br /> IrlAddress Letter <br /> T IR 'DEf�ARTM)~[VT ElBackfiow Prevention for high hazard: <br /> Separate I Deferred Submittals Required, (dental,medical,animals,mortuary, <br /> p q hospitai,supportive housing) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: This Permit Is Approved by Public Works <br /> See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: 0 A Separate PW Permit is Required(Permit#:PW ) <br /> Review of As-Built Plans••NO FIRE FEE AND a Is fully digital <br /> Minimal or No Fire Scope-NO FIRE FEE a Is located in this folder <br /> Review/Inspection Scope-ADD FIRE FEE a is In aSeparate Green Folder potnwiththrsfotderforpermltissuance) <br /> Approved By. Date: p Will be Issued separately(separate Green Folder.PW fssued ahead of Bldg) <br /> Rtipl(c Works has-no scope on this permit---PW Not Required <br /> EJ-90TRICALIPLUMBING Additional Notes: <br /> [Approved <br /> dditional Notes: ` <br /> By: Date: Completed By. Date: Z j'>.L <br />