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Intake & Approval Sheet (FOR PERMIT STAFF ONL)q PERMIT# 7- !V3— C I I <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK b <br /> y: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone J <br /> ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement <br /> BldgITI/Addn/Rem Size LDo Nonresidential Use <br /> Garage/Accessory Struct. Size Residential Use <br /> Number of Stories 2, Proposed No.of Dwelling Units: <br /> Basement []No ❑Yes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction t> Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Occupancy Group "In Lieu"Fee:Type: _ Amount$ <br /> Occupancy Load School Impact Fee: Total 11,2 <br /> Cert.of Occpuancy Required? ❑No QYes ❑Shell Only Calculated: / Credit: <br /> Code Year ❑2021 02018. ❑2015 El Everett School Dist EfVukilteo School Dist <br /> Fire Sprinklers: ❑Update Existing uNew System ❑Not Req'd Park Impact Fees for permits applied for after 1/1/2022: <br /> Reason Sprinklers Required: Park Impact Fee Total S ?i 2 (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing MNew System El Not Req'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes o Additional Notes: -f-c <br /> VALUATION CALCULATION: Total$ <br /> �^tleh 0Wt(linof 2009SF x1t! 6G=333,4`14 Approved By: �_�Date: <br /> garage 4-pSsF ,cfbb= 25,�zo <br /> [ovcf(el Parch 24SF 53� <br /> j gt� tAlnr� rw�eWe� }o vcri �t lob, PUBLIC WORKS <br /> 50 <br /> Intake OK by: Date: <br /> Intake Comments: PW Review&Worksheet Needed if.• <br /> ' Sys Dev Eval: <br /> Additional Notes: QWater 'ElSewer I]Storm <br /> / hDAddress <br /> Traffic Mitigation Eval <br /> Approved By: Date: (.f ��� ite Work/Drainage(shovm/triggered) <br /> Letter <br /> FIRE DEPARTMENT ❑Backflow Prevention for high hazard: <br /> Separate 1 Deferred Submittals Required: (dental,medical,animals,mortuary, <br /> hospital,supportive housing) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> ❑See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: f A Separate PW Permit is Required(Permit 4: PW 2 k" <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital <br /> EKI-Minimal or No Fire Scope-NO FIRE FEE fl Is located in this folder <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Approved By: Date: .� ❑ 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 /> ELECTRICALIPLUMBING Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed B Date. L <br />