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/,fitwce 6 ApprOlial (MI r'.c,rxtvirI ,a/AIM'r' WIL..X) <br /> BUILDING • PWINING jfj.S fcj/k/C /09erEn <br /> Intake OK by: Date: intake OK by: Assigns o: 1)61 Date: tift A <br /> Intake Comments: Intake Comments: '! )vw toy? <br /> Zone 1 2, <br /> Overlay/Agreement A r�aa+ Cohl•I'1 A b <br /> El Route to Commercial Building Nonresidential Use f <br /> ❑ Route to Residential Building Residential Use <br /> ❑ Make this a"W"Permit Proposed No.of Dwelling Units: <br /> Bldg/lllAddnlRem Size Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? DYes NNo <br /> Number of Stories "In Lieu"Fee:Type: Amount$ <br /> Basement ONo DYes, Fin/Unfin School impact Fee: Total $ INA <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/112022: <br /> Fire Sprinklers:ElUpdate Existing ONew System ❑NotReq'd Park Impact Fee Total$ t'�IA (net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: DUpdate Existing [New System :Not Req'd Permit Technician Use Only:Apply Phase-In Credit PerEMC19.53.200 <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? DYes }l No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'l RCW 64.55 does required prior to final? DYes CINo El 0%Credit-issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ Additional Notes: <br /> Approved By: W. Date: 7 Jv, .13 <br /> P•U13I_IC WORKS • • <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed/t: <br /> ❑Sys Dev Eval(UtillsW)ElTraffic Mit Eval <br /> Approved By: i' Date: ,5b2 {{ a,' psite Work/Drainage DAddress Letter <br /> ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> FIRE I]EPARTIiMIENT • supportive housing) <br /> Separate/Deferred Submittals Required: DRoute this folder for PW Review at end --PW Review Worksheet <br /> OFire Sprinklers ❑Firo Alarm Other: OThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND OCreate Green Folder OSubmiitted Previously ❑Deferred <br /> El This Permit is Approved by Public Works <br /> Fire Dept.Fees: El 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#: PW ) <br /> CI Minimal or No Fire Scope-NO FIRE FEE AND CI is located in this folder <br /> El Review/inspection Scope ADD FIRE FEE 0 is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By: Date: El Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> CI Public Works has no scope--PW Not Required <br /> ELJ CTRICALIRLUiVIBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: Date: <br />