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Infake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK Icy: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Rorie <br /> ❑Maka this a"W"Permit ❑SRC Re ulrad (Pre-!nip) OverlaylAgreement <br /> BidglTI/Addn/Rem Size Nonresidential Use <br /> Garage/Accessory Struct.Size Residential Use <br /> Number of Stories R Proposed No.of Dwelling Units: <br /> Basement No CIYeS, Fin I Unfin Total No.of Dwelling Units: <br /> Type of Construction PlanninglLandscape Inspection Required before Final? E]Yes allo <br /> Occupancy Group "In Lieu"Fee:Type: Amount$ <br /> Occupancy Load School Impact Fee: Total $ <br /> Cert, of Occpuancy Required? ENo ElYes Shell Only Calculated: Credlt: <br /> Code Year 02021 02018 112015 Everett School Dist ElMuklitea School Dist <br /> Fire Sprinklers:[]Update Existing EINew system INNot Req'd Park Impact Fees for permits applied for after 11112-022: <br /> Reason Sprinklers Required: Park Impact:Fee Total$ (net due after credit for existing uses) <br /> Fire Alarm: OUpdateExistingUNewSystem HNotReq'd Fee Schedule Used For Calculation(Year): <br /> Reason Fire Alarm Required: <br /> RCW 64.55 MF worksheetre¢d for pern V []Yes No <br /> Add'IRCW.64,55 does required priortofinal? DYes MNo Additional Notes: <br /> =UA'I'ION CALCULATION: Total$ <br /> Approved By., Date: <br /> PUB.LICWoRKS <br /> Infake OK by: Rafe: <br /> Intake Comments: pyyReview&NlorksheetNeeded y <br /> i 'ElSys Dev Eval: <br /> Additional Notes: 1 ElWater �sewer astorm <br /> IQTraffrc Mitlgatictr Eval, <br /> Approved Sy: C, Date: f0SiteWorklDrainage(shown/triggered) <br /> jElAddress Letter <br /> L <br /> Pigli'DEPARTM W 11❑eackflow Prevention for high hazard: <br /> Separate I Deferred Sub Required, !hospital,supportive housing) <br /> Fire Sprinklers IIFire Alarm ❑Other: <br /> Additional Notes: PThis Permit Is Approved by Public Works <br /> El See PW Review Worksheet and associated attached Items <br /> Fire Dept:Fees: EJ 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 /> E]Review/Inspection Scope-ADD FIRE FEE ,El Is in a Separate Green Folder Uorrrw;ththrsfolderforpermftIssuance) <br /> Approved Dy: gate: Will be issued separately(Separate Green Folder,PW Issued ahead of9ldg) <br /> p Public Works has-no scope on this permit---PW Not Required <br /> .2JXOT.RIeAL1pLUMRING Additional Notes: <br /> Additional Notes: ` <br /> Approved By: Uate: Comptefed Date: 0 <br />