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Intake &Approval Sheet (FOR PERMIT STAFF ONL1� <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 J,T Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use <br /> Number of Stories J Proposed No.of Dwelling Units: <br /> Basement ®No ❑Yes, Fin/Unfin Total No.of Dwelling Units: <br /> Type of Construction 1712L Planning/Landscape 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? 13No ❑Yes ❑Shell Only Calculated: Credit: <br /> Code Year 112021 U2018 112015 ❑Everett School Dist ❑Mukilteo School Dist <br /> Fire Sprinklers: El Update Existing ❑New System []Not Req'd Park Impact Fees for permits applied for after 11112022: <br /> Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: ❑Update Existing El New System Mot 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'1 RCW 64.55 does required prior to final? ❑Yes ®No Additional Notes: <br /> VALUATION CALCULATION: Total$ J�jj/ <br /> Approved y: Date: l Z \5 2 <br /> ORKS <br /> Intake OK by: Date:_ <br /> Intake Comments: PIN Review&Worksheet Needed if. <br /> []Sys Dev Eval: <br /> II ❑Water ❑Sewer ❑Storm <br /> Additional Notes: - I <br /> []Traffic Mitigation Eva[ <br /> Approved By. Date: l I[]Site Work/Drainage(shown/triggered) <br /> i <br /> []Address Letter <br /> FIRE DEPARTMENT i(dental, <br /> []Backflow Prevention for high hazard: <br /> Separate I Deferred Submittals Required: ' 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: ❑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(icinwiththisfolderforpermitissuance) <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 By: Date: Completed By,—,I' U Date: <br />