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l'.<144 s i oi,J . ier-i--kt--- - ft,e ID flookrici-L.. <br /> Intake &Approval Sheet PERMIT STAFF ONLY) LIT#. 45,3011— <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone 7/ /� <br /> ❑ Make this a"W"Permit 0 SRC Required(Pre-Insp) Overlay/Agreement <br /> Bldg/Ti/Addn/Rem Size [ r Nonresidential Use — <br /> Garage/Accessory Struct.Size 1j I l Residential Use <br /> Number of Stories Proposed No.of Dwelling Units: <br /> Basement 66lo ❑Yes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction et Planning/Landscape Inspection Required before Final? )DYes ❑No <br /> Occupancy Group C c, "In Lieu"Fee:Type: r-- Amount$ <br /> Occupancy Load I - School impact Fee: Total $ / — <br /> /,%/ <br /> Cert.of Occpuancy Required? ❑No 1Yes ❑ Gz <br /> Shell Only Calculated: / , , Credit: -60---- <br /> Code Year Djr, E2018 02015 ❑Everett School Dist MMiukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing1_INew System JlNot Req'd Park Impact Fees for permits applied for after 11112022: <br /> _. Reason Sprinklers Required: T t'' St UMl5 Park Impact Fee Total$ 233/ (net due after credit for existing uses) <br /> • Fire Alarm: DUpdate Existing❑New System fiNot Req'd Fee Schedule Used For Calculation(Year): „c-„0 Z^e N11 <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? DYes 0 No ,�! <br /> Addl RCW.64.55 dots required prior to final? DYes �7i o Additional Notes: Y 4d/ / /61- 56,1 y �i i; <br /> .VALUATION CALCULATION: Total$ .voldi il, �/ �/ <br /> ?X7 X I66 �� & -� s 03. Approved By: i re, � Dete: -/S--2% <br /> i <br /> � 6(Y 'a O ce r PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Review&Worksheet Needed if: <br /> • DSys Dev Eval: <br /> • <br /> Additional Notes:Additional <br /> DSewer ❑Storm <br /> OTraffic Mitigation Eval <br /> Approved By., 1A Date: ( /c/)1 f El Site Work/Drainage(shown/triggered) <br /> DAddress Letter <br /> FIRE DEPAR TMENT OBackflow Prevention for high hazard: <br /> (deSeparate/Deferred Submittals Required: hospitaal,l, <br /> supportive <br /> animals,mortuary, <br /> P q hospital,supportive housing) <br /> OFire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: VI This Permit is Approved by Public Works <br /> . 0 See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#:PW ) <br /> ❑Review of As-Built Plans-NO FIRE FEE AND 0 Is fully digital <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is located in this folder <br /> -Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder(joinwiththisfoiderforpermitissuance) <br /> Approved By ,1j(,vy1 Date: 12,i g .e? 0 Will be issued separately(Separate Green Folder,PW issued ahead of aldg) <br /> ❑Public Works has no scope on this permit---PW Not Required <br /> • ELECTRICAL/PLUMBING . Additional Notes: <br /> Additional Notes: I `D EcrOt in "MAC love 4 <br /> Approved By: Date: Completed By:Ay(/UA Q..k rYv)", Date: 12.1 lb 1282,8 <br />