Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF ONL PERMIT# 6 2-t0Z ' 00 8 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone Z /77 <br /> ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement <br /> Bidg/TI/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use <br /> Number of Stories Z Proposed No,of Dwelling Units: <br /> Basement No ❑Yes, Fin/Unfin Total No.of Dwelling Units: i <br /> Type of Construction Planning/Landscape Inspection Required before Final? Yes ❑No <br /> Occupancy Group I "In Lieu"Fee:Type: — Amount$ <br /> Occupancy Load School Impact Fee: Total $ l/� <br /> Cert.of Occppancy Required? ❑No Yes ❑Shell Only Calculated: 11.21 Credit: <br /> Code Year 112021 N12018. 112015 []Everett School Dist Mukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing El Now System Not Req'd Park Impact Fees for permits applied for after 111/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ 3.3 7/ r(net due after credit for existing uses) <br /> Fire Alarm: El Update Existing ❑New System Not Req'd Fee Schedule Used For Calculation(Year): p? U <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes El No <br /> Add'I RCW 64.55 docs required prior to final? []Yes IDNo Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> "J( ev)" bWtj(;n' 2009 SF xf1 bG 333,414 Approved By: l' c Date: - z <br /> 4aragt +05 SP x 25,1 <br /> (t,vcrcol porch 24SF >t4 1,536 PUBLIC WORKS <br /> fi.l�tnilding revt�we� }o veniG�� 3lob,`l 5� <br /> Intake OK by:�_ Date: <br /> Intake Comments:— PWRevlew&WorksheetNeeded If.• <br /> Dev f&S far (Sys Dev Eval: <br /> Additional Notes: <br /> ` Water DpSewer r torm <br /> ru� Traffic Mitigation Eval <br /> Approved By: Date: C(�yIV(40 ) 1 t1 C Traffic <br /> WorkfDrainage(shown/triggered) <br /> (l if� W � ��S i ddress Letter <br /> FIRE DEPARTMENT [l S��c / � ❑Backffow Prevention for high hazard: <br /> (dental,medical,animals,mortuary, <br /> Separate 1 Deferred Submittals Required: <br /> j� hospital,supportive housing) <br /> OFIre Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: %This Permit is Approved by Public Works <br /> ks <br /> ee PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: Separate PW Permit is Required(Permit#:PW A-�- "0 ) <br /> ❑ 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 /> ❑ Review/Inspection Scope-ADD FIRE FEE Is in a Separate Green Folder Qoin with this folderfor permit Issuance) <br /> Approved By: Date: El 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 /> ELECTRICALIPL'UMBING Additional Notes: / J <br /> Additional Notes: W P�(u`'f S ?Iyey-`Je6�l! <br /> Approved By: Date: Completed By: Date: <br />