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Intake &Approval Sheet •iu (FOR PERMIT STAFF ONLY) Eli PERMIT# C'\ (:)( C512 <br /> BUILDING PLANNING <br /> Intake OK by: • Date: Intake OK by: Date: <br /> Intake Comments: 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 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone C 1 <br /> Number of Stories Overlay/Agreement <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <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? ❑Yes gNo <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 Sc of Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes 0 N Additional Notes: 't G ,Q405\1 *(Z'SV 5 (eAA.ad/ <br /> VALUATION CALCULATION: Total$/3'8.8,00 Gia Wt�'t�•- �1�.n3 rui,S iLRJ Small 102_i'*1— <br /> f2 �lrQ_ MfA `-^k <br /> Approved By: K—. l Date: • ,_is--t 1 61 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet eded if:: <br /> ❑Sys Dev E :I ❑Traffic Mit Eval <br /> ❑Site W. or Drainage Proposed <br /> Approved B Date:p�� ❑Bac• ow Prevention for high hazard: <br /> /a (den.,medical,animals,mortuary,hospital, <br /> s .portive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review-t end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separ:'e concurrent PW Review(Green Folder) <br /> El Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folde ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approv-• by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review .rksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW 'ermit is Required (Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is loc. ed in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is i a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ❑ II be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public orks has no scope---PW Not Required <br /> Addition.• Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />