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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 62/44 N. 2 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: v 7 1 Date: 51'7 f262L/ <br /> Intake Comments: Intake Comments: <br /> Zone `Z.- <br /> ❑ Make this a "W" Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement <br /> ,Bldg/TI A do em Size 4- S---au S f (e,L' t U444) Nonresidential Use <br /> Garage ccessory Struct. Size t-OJ 5 f Ca,C4t (,ruin') Residential Use T2z Ie.)C <br /> Number of Stories _ -4 / Proposed No. of Dwelling Units: — C2 exr3i-+li <br /> Basement 15ZINo Oyes , Fin/Unfin Total No. of Dwelling Units: 2. <br /> Type of Construction I Fl. Planning/Landscape Inspection Required before Final? ❑Yes DNo <br /> Occupancy Group `/ "In Lieu" Fee: Type: Amount$ <br /> Occupancy Load V School Impact Fee: Total $ <br /> Cert. of Occpuancy Required? ❑No tptYes ❑Shell Only Calculated: 262`i Credit: <br /> Code Year 'g2021 02018 02015 .Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing ❑New System LC Not Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: El Update Existing El New System ONot Req'd Fee Schedule Used For Calculation(Year): 76Z4( <br /> Reason Fire Alarm Required: 4 v./-k ppcc.a.� _ Uail-- <br /> RCW 64.55 ME worksheet req'd for permit? ❑Yes p No Q./•ev�k- I (QS S ' "- 7,'. —row t w w <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes VI.No Additional Notes: ( .iv-er+')"-t `�" �g (� <br /> VALUATION CALCULATION: Total $_ i-e ( �� .1-.,i K� : ,yt%{- n' � )to e�c�(�d,� ,'_�" DR -Pip 2 � <br /> - ��6 ,7J Approved By: / - Date: 6/fir/2 Li <br /> 5-61) crb6 ; aii- e71,,' <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: 1PW Review&Worksheet Needed if: <br /> ❑Sys Dev Eval : <br /> Additional Notes:+n J,V y ej t ti.- L m.esrk-u�l i ❑Water ❑Sewer ❑Storm <br /> I, i <br /> I ;❑Traffic Mitigation Eval <br /> Approved By: LI,( Date:(/(/. /7iy' ❑Site Work/Drainage(shown/triggered) <br /> (/` `"' III I❑Address Letter <br /> FIRE DEPARTMENT 10Backflow Prevention for high hazard: <br /> Separate/Deferred Submittals Required: `(dental,medical,r ve animals,oui mortuary, <br /> hospital,supportive housing) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: l <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 /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital <br /> El Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By: Date: 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 /> ELECTRICAL/PLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed B .. Date: G 4(wi-f'2o2-4- <br />