Laserfiche WebLink
intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # <br />BUILDING <br />intake OK by: Date: <br />Intake Comments: <br />❑ Make this a "We Permit <br />❑ sRC Required (Pre -Ins ) <br />1314TIlAddnlRem Size op <br />Garage/Accessory Struct. Size <br />N h <br />Number of Stories <br />Basement <br />No DYes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Cott, of Occpuancy Required? <br />[]No Yes []Shall Only <br />Code Year <br />112021 &018 112016 <br />Fire Sprinklers: Update Existing ❑New system []Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: UpdateExlstingLl Now system []NotReq'd <br />Reason Fire Alarm Required: <br />RCW64,65MFworksheetreq'dfor permit? DYes INNo, <br />Add'I RCW 64.55 does required prior to final? Mee 5aND <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />Z. <br />Approved B Date: 3 1 7TT <br />IE <br />Ilk DEPARTMW <br />Separate I Deferred Submittals Required: <br />Ye Sprinklers Mira Alarm ❑Other: <br />Additional Notes: . <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans- NO FIRE FEE <br />❑ Minimal or No Fire Scope- NO FIRE FEE <br />eview/ Inspection Scope - ADD FIRE FEE <br />Approved By: c,,� Date: �_ <br />HIXOTRICAUPLUMEIING <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />intake OK by: Assign To:, J 0 S Date: 2 17. 7.t <br />Intake Commen <br />Zone <br />Overlay/Agreement <br />lath ti-ACA <br />NonresldentialUse <br />r¢}att wtesRser-vic•e5 <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No, of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes KNo <br />"In Lleu" Fee: Type: Amount $ 0 <br />School Impact Fee: Total $. <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukllteo School Dist <br />Park Impact Fees for permits applied for after 11112022: <br />Park Impact Fee Total S D (net due after credit for existing uses) <br />Fee schedule Used For calculation (Year): <br />Additional Notes: <br />Approved By: Dater Z2 2N <br />PuBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: pWRevlow& Worksheet Needed if.• <br />[]Sys Dev Eval : <br />❑Water USewer UStorm <br />❑Traffic Mitigation Eval <br />USite WoddDralnage (shownitriggered) <br />❑Address Letter <br />FIBackdow Prevention for high hazard: <br />(dental, medical, animals, mortuary, <br />• hospital, supportive housing) <br />❑ This Permit Is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached Items <br />❑ A Separate PW Permit is Required (Permlt#: PW ) <br />AND ❑ Is fully digital <br />El Is located In this folder <br />El Is In a Separate Green Folder doin with this foiderfor permitissuance) <br />❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />Public Works has.no scope on this permit--- PW Not Required <br />Additional Notes: <br />Completed Ely:1 Q <br />U <br />L <br />