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Intake &Approval Sheet (FOR PERMIT STAFF ONLY PERMIT#(, tS 12 `co <br /> BUILDING PLANNING <br /> Intake OK by: Date: 1Z/l 9 ll o Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> Et Route to Residential Building 0 Route to Historic Reviewer <br /> O 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/Accessory Struct.Size Zone <br /> Number of StoriesOverlay/Agreement <br /> rr++ <br /> Basement ❑No Cil <br /> Yes , bir nfin Nonresidential Use �-�— <br /> Type of Construction Residential Use <br /> Occupancy Group <br /> Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of DwellingUnits: `�- <br /> p Y <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ONo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <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? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes 0 N Additional Notes: <br /> VALUATION CALCULATION: Total$ 1 0 00 0 <br /> Approved By:clilru7 Date: �� /1 le <br /> PUBLIC WORKS <br /> Intake OK by: 8% Date: 12 I et /2 o r <br /> Additional Notes: Z o(S G'SaG Intake Comments: PW Worksheet Needed if: <br /> fossTWs.ost Z EM.oro L ❑Sys Dev Eval ❑Traffic Mit Eval <br /> o . o bvTs ram ❑Site Work or Drainage Proposed <br /> Approved By: Date: i/zi,', VJor .• ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alleyload SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: PA Public Works has no scope---PW Not Re. ired <br /> Ad•itional Notes: /__-- <br /> ELECTRICAL <br /> Additional Notes:. <br /> Approved By: Date: Approved By: Date: <br />