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Intake &Approval Sheet (FOR PERMIT STAFF OIVL.N9 PERMIT#, <br /> 13UILDING PLANNING <br /> intake OK by: Date: Intake OK by: Assign To*luen Date: <br /> Intake Comments: intake Comments: <br /> Zone <br /> ❑Make t le a"W"Permit ❑SRC Re ulred Pre-Inap) Overlay/Agreement <br /> Bldg/TI dd em Size �V S ti�� Nonresidential Use <br /> Garage/Accessory Struct- Size 0 Residential Use S <br /> Number of Stories Proposed No,of Dwelling Units: <br /> Basement No QYes, Fin 1 Unfin Total No.of Dwelling Units: <br /> Type of Construction L planning/Landscapa Inspection Required before Final? QYes No <br /> Occupancy Group r In Lieu"Fee:Type: Amount$_ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cart.of Occpuancy Required? QNo 14Yes QShell Only Calculated: Credit: QS <br /> Code Year Q2021 M2018 112016 []Everett School Dist QMukllteo School Dist <br /> Fire Sprinklers:[]Update Existing[]New System PNot Req'd Park impact Fees for permits applied for after 111/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ ' C06 (net due after credit for existing uses) <br /> Fire Alarm' QUpdate Existing El New System EANot Req'd Fee Schedule Used For Calculation(Year) <br /> Reason Fire Alarm Required: <br /> RCW 64.86 MF worksheet req'd for permit? QYes No <br /> Add'I RCW.64.66 does required prior to final? ❑Yes No Additional Notes: typ <br /> VALUATION CALCULATION: Total$-- (U <br /> Approved By: Date: C>31 t2. <br /> 20� <br /> PUBLIC•V 014KS <br /> Intake OK by: Date: <br /> Intake Comments: AWReviery&WorksheetNeeded If,• <br /> ❑Sys Dev Eval: <br /> Additional Notes: ElWater ElSewer IlStorm <br /> ❑Traffic Mitigation Eval <br /> Approved By: Date: /( 7 ([ISite Work/Drainage(shown/triggered) <br /> �TIAddress Letter <br /> FIRR DEOARTM�NT �OBackfiow Prevention for high hazard: <br /> (dental,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Required: hospital,supportive housing) <br /> []Fire Sprinklers ❑Fire Alarm QOther: <br /> Additional Notes: Q This Permit Is Approved by Public Works <br /> Q See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: Q A Separate PW Permit Is Required(Permit#:PW ) <br /> Q Review of As-Built Plans-NO FIRE FEE AND Q is fully digital <br /> Q Minimal or No Fire Scope-NO FIRE FEE Q Is located In this folder <br /> P�Review/inspection Scope-ADD FiRE FEE Q Is In a Separate Green Folder((otnvBth this folderforpermitIssuance) <br /> Approved fay: Date: - Q Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> rypublic Works has-no scope on this permit--••PW Not Required <br /> ELMOTRICAL/ALUM$ING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: lCompleted By: Date:p L Z 4• to L4 <br />