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Intake &Approval Sheet (F PERMIT STAFF ONLY) RMIT# ?- °7 O9 O <br /> BUILDING FLAKING <br /> Intake OK by: Date: Intake OK by: Assign To: Jess Date: 7/2(0123 <br /> Intake Comments: Intake Comme ts: <br /> Zone <br /> Overlay/Agreement Ord. 5(0(0(0 AIg4 AGA <br /> ElRoute to Commercial Building Nonresidential Use War ehouse) '5,,; .'ek °'(.1 <br /> ❑ Route to Residential Building Residential Use tom)/A <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: N/A <br /> Bldg/TI/Addn/Rem Size Total No.of Dwelling Units: 1J/ft <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes ID-No <br /> Number of Stories "In Lieu"Fee:Type: Amount$ 0 <br /> Basement ❑No ❑Yes, Fin/Unfin School Impact Fee: Total $C> <br /> Type of Construction 11 �p� Calculated: Credit: <br /> Occupancy Group ❑Everett 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 El New System El Not Req'd Park Impact Fee Total$0 <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: El Update Existing El New System El Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 <br /> Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No 0 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No 0 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ ' .OD o n Additional Notes: <br /> Approved By:A4-4 Date: 7/2161Z3 <br /> PUBLIC WORKS <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: IPWWorksheetNeededif: <br /> ❑Sys Dev Eval DTraffic Mit Eval <br /> L c0J',4.1, Date: 'Mite Work or Drainage Proposed <br /> Approved By: <br /> t Rf lat` lDBackflow Prevention for high hazard: <br /> i(dental,medical,animals,mortuary,hospital, <br /> FIRE DEPARTMENT isupportive housing) <br /> Separate I Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑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: ❑ See PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FIRE FEE ❑ A Separate PW Permit is Required(Permit#: PW <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder <br /> ®-Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By: , ),1-2,,Ui n Date: a2R ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> y Public Works has no scope--- PW Not Required <br /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Approved By: AA•r 5•811" Date: 07 , 10 ..Z3 <br />