Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# V2)(2.0(i;"-D3d- <br /> BUILDING <br /> PLANNING <br /> Intake OK by: :4� Date: to L Intake OK by: Date: <br /> •Intake Comment 4 Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 10,3 7Y 4) 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone cl — \ c <br /> Number of Stories Overlay/Agreement <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use C)�1'.�E- C.k. <br /> Type of Construction / -"-c7.- Residential Use --- <br /> Occupancy Group 13 Proposed No. of Dwelling Units: <br /> Occupancy Load /03 Total No.of Dwelling Units: , <br /> Fire Sprinklers: ❑Update Existing ❑New System'Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 0N <br /> Reason Sprinkles Required: ,��,,{{ "In Lieu"Fee:Type: -Amount$ <br /> Fire Alarm: d to i ti g ❑ J�I <br /> New System Not Req'd School Impact Fee: Tota <br /> Reason Fire Alarm Required: - ,C 1CMJ Calculated: Credit: _ <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes gl No ❑Everett School Dist ❑Mukilteo School Dist. <br /> Add'I RCW 64.55 docs required prior to final? ❑Yeso Additional Notes: <br /> VALUATION CALCULATION: Total$ /Uc 7 CO <br /> Approved By T -' Date: (C(p / cc _ <br /> PUBLIC WORKS <br /> Intake OK by:6A-p,4- Date: g��/? g <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> jlk) S e-- ❑Site Work or Drainage Proposed <br /> Approved By: --r-L Date: g",-(// ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR, -w Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Pre/ inary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Proje eam 0 This Permit is Approved by Public Works <br /> Date: (O to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Up•: e Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: El.Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical i p: ❑Update Existing ❑New System 0 Not Req'd ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: , ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: L!� Date: Or Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELEC CAL <br /> Additional Notes: ' <br /> r <br /> Approved By: Date: Approved By: . Date: 2 .e <br />