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Intake &Approval Sheet (F i+PERMIT STAFF ONLY) PERMIT# ?oZ.304 -0?f <br /> BUILDING PLA T" <br /> Intake OK by: Date: intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> El Route to Commercial Building Nonresidential Use <br /> ❑ Route to Residential Building Residential Use <br /> El Make this a"W"Permit Proposed No.of Dwelling Units: <br /> Bldg/TI/Addn/Rem Size 1727 Total No.of Dwelling Units: <br /> Garage/Accessory Struct.Size 4-(( Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Number of Stories _j "in Lieu"Fee:Type: Amount$ <br /> Basement INo ❑Yes, Fin/Unfin School impact Fee: Total • /J * <br /> '• <br /> Type of Construction Calculated: /6/114 Cre it: 4 <br /> Occupancy Group ❑Everett School Dist Fllukilte School Dist <br /> Occupancy Load 1 Park Impact Fees for permits aeli for after'I/1/2022: <br /> Fire Sprinklers: QUpdate Existing Mew System ONot Req'd Park impact Fee Total$ 7/e5U net due after credit for existing uses) <br /> Reason Sprinklers Required: (I"/ S (AA-& Fee Schedule Used For Calculation(Year): t 6Z—) <br /> Fire Alarm: ❑Update Existing ONew System allot Req'd Permit Technician Use Only:Apply Phase-in Credit Per BIM 9.53.200 <br /> Reason Fire Alarm Required: ❑ 100%Credit-issued 1/1/2022-9/2/2022 <br /> �-y <br /> RCW 64.55 MF worksheet req'd for permit? DYes I, No El 50%Credit-Issued 9/3/2022-6/2/2023 <br /> Add'1 ROW 64.55 docs required prior to final? ❑Yes I�No ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total$ 3/S'Cl2.4 Additional Notes: <br /> Approved By: .5 --"". Date: 23 <br /> PUBLIC WORKS . . • <br /> Additional Notes: Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if <br /> ❑Sys Dev Eval(tltiifSW)DTraffic Mit Eval <br /> Approved By: J Date: 7//4/)._"� ❑Site Work/Drainage ❑Address Letter <br /> ❑Backfiow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> •FIRE DEPARTMENT supportive housing) <br /> Separate 1 Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review iWorksheet <br /> IG1t ire Sprinklers ❑Fire Alarm Other: EIThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND ®Create Green Folder ❑Submitted Previously !—!Deferred <br /> iSa This Permit is Approved by Public Works <br /> Fire Dept.Fees: laSee PW Review Worksheet and associated attached items <br /> ❑Review of As-Built Plans-NO FIRE FEE RA Separate PW Permit is Required(Permit#: PWaaO5'-O ) <br /> El Minimal or No Fire Scope-NO FiRE FEE AND El 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:V.: �-©`AA\ Date: G,1 l be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Public Works has no scope—PW Not Required <br /> ELECTRICAL/RLUMI3ING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed By: j't Date: St I I I:L <br />