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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# . - 3 D q.— 0 a Tf <br /> BUILDING . +ANNING <br /> Intake OK by: Date: Intake OK by: . Assign To: J ess Date: LI 12 0/23 <br /> Intake Comments: Intake Commen <br /> Zone MU <br /> Overlay/Agreement WA <br /> El Route to Commercial Building Nonresidential Use 1jI Are,vno'Jse. <br /> El Route to Residential Building Residential Use V.311. <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: 141 A., <br /> Bldg(11/Addn/Rem Size ►'3 rj'°(.e}- $4-2- Total No. of Dwelling Units: N/A <br /> Garage/Accessory Struct.Size — Planning/Landscape Inspection Required before Final? ❑Yes ' No <br /> Number of Stories "In Lieu"Fee:Type: Amount$ O <br /> Basement NNo CIYes, Fin/Unfin School Impact Fee: Total $ 0 <br /> Type of Construction `!-6 _ Calculated: Credit: <br /> Occupancy Group El Everett School Dist DMukilteo School Dist <br /> Occupancy Load 28 Park Impact Fees for permits applied for after'II'I12022: <br /> Fire Sprinklers: ❑Update Existing ONew System alNot Req`d Park Impact Fee Total$ 0 (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: %I Update Existing ONew System ❑Not Req`d Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 <br /> Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF worksheet req'd for permit? DYes ��i No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add1 ROW 64.55 docs required prior to final? QYes JNo ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ 40rory) Additional Notes: <br /> Approved Byleal-t 44.4_ Date: c.I /Z O 1 Z 3 <br /> PUBLIC WORKS • <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed/ <br /> QSys Dev Eval(Util/SW)❑Traffic Mit Eval <br /> Approved By: ci " Date:+ 13i / One Work/Drainage DAddress Letter <br /> ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT • supportive housing) <br /> Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end --PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: EIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND EICreate Green Folder ®Submitted Previously ❑Deferred <br /> ❑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 It: PW ) <br /> El Minimal or No Fire Scope-NO FIRE FEE AND 0 Is located in this folder <br /> J2-Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folderfor permit issuance) <br /> Approved By:Ki `(7cit/n Date: 2( ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> 6 -7.23 Public Works has no scope--PW Not Required <br /> ELECTRICAL/RLUMBIIVG • dditional Notes: <br /> Additional Notes: 414)M/IN )tip 'v44_1 o4 I 1'1 I Zv23 <br /> Approved By: Date: Completed l y: Date: <br />