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tnzaKe 6c HpprOVat Zineer (1-UK .f ,ctVVJ1 i Z I At-t- u1VLY) PERMIT <br /> BUILDING <br /> P' "NN1NG <br /> intake OK by: Date: intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> Overlay/Agreement <br /> Route to Commercial Building Nonresidential Use <br /> Route to Residential Building Residential Use <br /> Make this a"W"Permit Proposed No,of Dwelling Units: <br /> Bldg/TI/Addn/Rem Size Total No,of Dwelling Units: <br /> Garage/Accessory Struct.Size Planning/Landscape inspection Required before Final? ElYes No <br /> Number of Stories "in Lieu"Fee:Type: Amount$ <br /> Basement 0No aYes, Fin/Unfin School Impact Fee: Total $ <br /> Type of Construction Calculated: Credit: <br /> Occupancy Group ElEverett School Dist ❑Mukilteo School Dist <br /> Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: <br /> Fire Sprinklers: OUpdate Existing EINew System ❑Not Req'd Park Impact Fee Total g „(net due after credit for existing uses) <br /> Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): <br /> Fire Alarm: ❑Update Existing ❑New System C1Not Req'd Permit Technician-Use Only:Apply Phase-in-Gtedit Per <br /> Reason Fire Alarm Required: 11 100%Credit-Issued 1/1/2022-9/2/2022 <br /> RCW 64.55 MF tyorksheet req'd for permit? ElYes 11 No ❑ 50%Credit••Issued 9/3/2022-6/2/2023 <br /> Add'l RCW 64.55 docs required prior to final? ❑Yes 0No ❑ 0%Credit-Issued 6/3/2023 or later <br /> VALUATION CALCULATION: Total , ° o ° Additional Notes: <br /> Approved By: Date: <br /> PUI30C WORKS <br /> Additional Notes: Intake OK by: Date: <br /> ...................--------------..... <br /> ---- <br /> Intake Comments: ;PW Worksheet Needed If.• <br /> ;bSys Dev Eva[(utitts"❑Traffic Mit Eva[ <br /> !Approved Date:o7 / Z 'ElSite Work/Drafnage LIAddress better <br /> I lBackflow Prevention for high hazard: <br /> (dental,medical,antmals,mortuary,hospital, <br /> FIRE I]EPARTMENT ,supportive housing) <br /> - <br /> Separate l Deferred Submittals Required: ❑Route this folder for PW Review at end --PW Rev/etiv Worksheet----- <br /> QFiro Sprinklers ❑Fire Alarm Other: OThis project also has a separate concurrent PW Review(Green Folder) <br /> Additional Notes: AND Create Green Folder []Submitted Previously ElDeferred <br /> 0 This Permit Is Approved by Public Works <br /> Fire Dept,Fees: EJ See PW Review Worksheet and associated attached items <br /> 11 Review of As-Built Plans NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW ) <br /> Minimal or No Fire Scope.•NO FIRE FEE AND El Is located in this folder <br /> El Review/inspection Scope..ADD FIRE FEE 11 Is in a Separate Green Folder(join with this folderfor permitissuance) <br /> Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW Issued ahead of Otdg) <br /> 0 Public Works has no scope--PW Not Required <br /> EL.ECTRICALIN.LUMBiNG Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Completed)3y: Date: I�/L <br />