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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 4 I'l07-gob <br /> BUILDING PLANNING <br /> Intake OK by: dn." Date: ?Ai Iiq Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> O Route to Commercial Building 0 Attach to Project No. <br /> O 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 0 Hold in Planning File Drawer <br /> Garage ccesso Struct. Size 'Cf 2. SJ Zone - [1 J <br /> Number of Stories Overlay/Agreement <br /> Basement ElNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction l Residential Use `t <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: A •. t$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes ® No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes i'No Additional Notes' <br /> VALUATION CALCULATION: Total$ SOO <br /> Approved By: all5 Date:`7/4/1 1 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: 2 Q/5— 'IQC Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: 7/61 Acs ❑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 /> Separate I Deferred Submittals Require/-- ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ! 0 This Permit is Approved by Public Works <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW <br /> ❑ Review of •'-Built Plans-NO FIRE FEE AND 0 Is located in this folder <br /> ❑ Mini v.: or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ r4ew/Inspection Scope-ADD FIRE FEE , 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope---PW Not Required. <br /> •,'diPl ( <br /> nal Notes: <br /> ELECTRICAL ' 6 / <br /> Additional Notes: ���� <br /> Approved By: • Date: Approved By: Date: <br /> /_ <br />