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or, Aw. / eat PI(,A►r,� <br /> 246 Z 01 <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#� Ty 1 <br /> BUILDING PLANNING <br /> intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Zone <br /> ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement <br /> Bldg/TI/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use <br /> Number of Stories Proposed No.of Dwelling Units: <br /> Basement []No ❑Yes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction PlanninglLandscape Inspection Required before Final? ❑Yes ❑No <br /> Occupancy Group "In Lieu"Fee:Type. Amount$ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cert.of Occpuancy Required? []No ❑Yes []Shell Only Calculated: Credit: <br /> Code Year 1112021 112018. 112015 []Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: []Update Existing ❑New System ❑Not Req'd Park Impact Fees for permits applied for after 1/112022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing ❑New System ❑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 []No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By., Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Review b Worksheet Needed if: <br /> ❑Sys Dev Eval <br /> j ❑Water ❑Sewer []StormAdditional Notes: � <br /> ❑Traffic Mitigation Eval <br /> Approved By: Date: ❑Site Work/Drainage(shown/triggered) <br /> 1❑Address Letter <br /> FIRE DEPARTMENT ❑Backflow Prevention for high hazard: <br /> ;(dental,medical,animals,mortuary, <br /> Separate/Deferred Submittals Required: <br /> ,hospital,supportive housing) <br /> El 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: ❑A Separate PW Permit is Required(Permit#:PW ) <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(join with this folderfor permit issuance) <br /> Approved By: Date: ❑ 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 B Date: O Completed By: Date: <br />