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intraKe 64 Approval Sheet (I-Ut< Y, I11iiiii i S l A.i°F ONLY) - PERMIT# 1303 off-•d 6 0 <br /> BUILDING aNNING • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments:.REv i22-004 <br /> Zone ryw <br /> Overlay/Agreement <br /> El Route to Commercial Building Nonresidential Use etrOr <br /> tna- - <br /> El Route to Residential Building Residential Use <br /> El Make this a"W"Permit Proposed No.of Dwelling Units: <br /> Bldglfl/Addn/Rem Size i) 72.,Q.. ' 4-4 Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size — PIanninglLandscape Inspection Required before Final? CIYeS E1No <br /> Number of Stories 1 "In Lieu"Fee:Type: Amount$ <br /> Basement ENo CIYes, Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction IL Calculated: • Credit: <br /> Occupancy Group M ❑Everett School Dist ❑Mukilteo School Dist <br /> Occupancy Load 1R-'-5 Park Impact Fees for permits applied for after 1/112022: <br /> FA <br /> Update Sprinklers: l�tUpdate Existing ONew System ❑Not Req'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: glUpdate Existing ONew System Mot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMCI9.53.200 <br /> Reason Fire Alarm Required: 1-t tit El 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCM/64.55 MF Worksheet req'd for permit? °Yes ►^_ryt No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'l ROW 64.55 does required prior to final? ❑Yes Y-'d No El 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ Ca ,evD Additional Notes: <br /> 'q).( 1a09 , ti1zg.`2`- <br /> Approved By: Date: t <br /> PUBLIC WORKS . <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed If: <br /> ❑Sys Dev Eval(UtiI/sW)I:Traffic Mit Eval <br /> Approved By: Date: /e//(2c)a.3 ❑Site Work/Drainage I:Address Letter <br /> . • OBackflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> •FIRE DIEPARTIVIENT ' • supportive housing) <br /> Separate/Deferred Submittals Required: EIRoute this folder for PW Review at end --PW Review Worksheet <br /> .Fire Sprinklers OFire Alarm Other: EIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND ElCreate Green Folder ❑Submitted Previously ❑Deferred <br /> • Q This Permit is Approved by Public Works <br /> Fire Dept.Fees: El See PW Review Worksheet and associated attached items <br /> ❑ Review of As-Built Plans-NO FIRE FEE El A Separate PW Permit is Required(Permit#: PW ) <br /> El Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder <br /> k-Review!Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved 13y:Y,,96-c,C. )r\ Date: `f _23 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Public Works has no scope--PW Not Required <br /> ELECTRICAL/KW/WING Additional Notes: <br /> Additional Notes: Al 1)4ext 4It' V l It/ \Imes 6 faua., <br /> Approved By: Date: Completed By: Date: <br /> -Ww't.vr..ktin v- ovl, 4121 2-3 <br />