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Intake &Approval Sheet FOR PERMIT STAFF ONLY HERMIT# -atfif <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> ❑Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement • <br /> Bidg/Tl!Addn/Rem Size l3 Nonresidential Use <br /> Garage/Accessory Struct_Size Residential Use <br /> Number of Stories ( • Proposed No.of Dwelling Units: • <br /> Basement INo 0Yes, Fin I Unfin Total No.of Dwelling Units: ' <br /> Type of Construction V.6 Planning/Landscape Inspection Required before Final? [(Yes [(No . <br /> Occupancy Group E "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load t{s School Impact Fee: Total $ <br /> Cert.bf Occpuancy Required? DNo IYes }Shell Only Calculated: Credit: <br /> Code Year 02021 I2018 02015 [(Everett School Dist LDMukilteo School Dist <br /> Fire Sprinklers:[(Update Existing[(New System 141Not Req'd Park Impact Fees for permits applied for after 11112022: <br /> _. Reason Sprinklers Required: Park Impact Fee Total$ ' (net due after credit for existing uses) <br /> Fire Alarm: [(Update Existing 2 New System [(Not Req'd Fee Schedule Used For Calculation(Year); n �_.M.,., <br /> Reason Fire Alarm Required: <br /> RCW 64.55 ME worksheet req'd for pert-lilt? [(Yes la No <br /> Add'I RCW 64.55 does required prior to final? [(Yes 12No Additional Notes: <br /> VALUATION CALCULATION: Total$ IffA 4 y vi _ <br /> Approved By: ( M/0624 <br /> Date: <br /> PU13.LIC WOIIKS 1 . <br /> Intake OK by:77. Date: 074 t 102- <br /> • Intake Comments: PW Review&Worksheet Needed ff <br /> dorKt9e` ysDevEval: <br /> Additional Notes: OWater bSewer Storm <br /> T-t4 f✓ ,DTraffic Mitigation Eva! <br /> 3 %nilrrV Pl S- !Mite Work/Drainage e shown/triggered <br /> Approved By: C.,,, 6 Date: tC/ f 9 ( ) <br /> AJO S'-te WOV* IDAddress Letter <br /> FIRE DEPARTNIENT P re d• !"d ?tu i❑Rackflow Prevention for high hazard: <br /> Separate 1 Deferred Submittals Required: `(dental,medical,animals,mortuary, <br /> q hospital,supportive housing) <br /> [(Fire Sprinklers ,Fire Alarm DOther: I • <br /> Additional Notes: . $This Permit is Approved by Public Works ' <br /> [(See PW Review Worksheet and associated attached items <br /> Fire Dept,Fees: ❑A Separate PW Permit is Required(Permit#:PW ) • <br /> El Review of As-Built Plans NO FIRE FEE AND ❑Is fully digital <br /> [(Minimal or No Fire Scope-NO FIRE FEE [( Is located In this folder <br /> FIReview/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder Uoin with this falderfor permit issuance) <br /> Approved By: 93 Date:„2-02_,,0 r? "J_(/ 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> �" [(Public Works has.no scope on this permit--PW Not Required <br /> BLEGTRICAL/PLUMBING Additional Notes: <br /> 6 <br /> Additional Notes: <br /> Approved By: Date: Completed Li F; /, , Jate:02,[4 f 702,4 <br />