Laserfiche WebLink
Intake &Approval Sheet OR PERMIT STAFF ONLY RMIT# <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/Ad e 'Z'52 UrU T iR> Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use 7' <br /> o-D ex <br /> Number of Stories Proposed No.of Dwelling Units: <br /> Basement 1KNo ❑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 $ g <br /> Cert.of Occpuancy Required? ❑No ffYes []Shell Only Calculated: Credit: <br /> Code Year 112021 M018 112015 Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: []Update Existing ❑New System ONot Req'd Park Impact Fees for permits applied for after 11112022: <br /> Reason Sprinklers Required: Park Impact Fee Total S '0 t.P (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Fee Schedule Used For Calculation(Year): '2LZ4 <br /> ------._.......�._. _____.,_ ____.._., .______ r.—.,...._-,______________ <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 RNo ditional Note <br /> VALUATION CALCULATION: Total$ 15.4UP> <br /> r-pproved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Review&Worksheet Needed if: <br /> OSys Dev Eval: <br /> 1 ❑Water ❑Sewer []Storm_ Additional Notes: - � <br /> OTraffic Mitigation Eval <br /> Approved By: Date:z S OSite Work/Drainage(shown/triggered) <br /> 1 DAddress Letter <br /> FIRE DEPARTMENT OBackflow Prevention for high hazard: <br /> Separate/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 /> rEl <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 /> S-Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Qoin%ith this folder for permit issuance) <br /> Approved By: Date: t ❑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 /> ELECTRICAUPLUMBING Additional Notes: <br /> Additional Notes: ' <br /> Approved By: Date: iCompletedBy: Date: f <br />