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► naIte Hpprovat Zneet r=11.IVftI aIHrI" UIVLY) PERMIT# vlS S —023 <br /> BUILDING • NNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> ❑ Route to Commercial Building Nonresidential Use <br /> ❑ Route to Residential Building Residential Use <br /> Make this a"W Permit Proposed No.of Dwelling Units: <br /> Bldg/TllAddn/Rem Sizp Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size Planningllandscape Inspection Required before Final? QYes ❑No <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement ONo ElYes, Fin/Unfin School Impact Fee: Total $ <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 1/112022: <br /> Fire Sprinklers:DUpdate Existing DNew System ❑NotReq'd Park Impact Fee Total$ (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: DUpdate Existing ®New System ONot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 <br /> Reason Fire Alarm Required: DYes El 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF Worksheet req'd for permit? DYes 0 No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'I RCW 64.55 docs required prior to final? DYes ONo El 0%Credit Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ Additional Notes: <br /> Approved By: Date: J <br /> PUBLIC WORKS • • ' - <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if: <br /> OSys Day Eval(ntil/SW)I:Traffic Mit Eval <br /> Approved By: Date: ElSite 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 EIFire Alarm Other: EIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND Create Green Folder ❑Submitted Previously ❑Deferred <br /> El This Permit is Approved by Public Works <br /> Fire Dept.Fees: 0 See PW Review Worksheet and associated attached items <br /> El Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#1:: PW ) <br /> El Minimal or No Fire Scope-NO FIRE FEE AND El Is located in this folder <br /> fl-Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join With this folder for permit Issuance) <br /> Approved 13y:V. a�� Date: .�3 Q Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> Public Works has no scope--PW Not Required <br /> EL)CTRICAALIRLUM.BING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: • Date: <br />