Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# JC.Ck0.`-k*-03 <br /> BUILDING PLANNING <br /> Intake OK by: ICH4 Date: 4/2i((/ 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 /SC( <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No. of Dwelling 'nits: <br /> Occupancy Load Total No.of Dwelling Ur ts: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscap- Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Typr. 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 fin-.? ■Yes EI Additional Notes: <br /> VALUATION CALCULATION: Tot- $ 5-00a <br /> Approved By: Date: <br /> \\....-I <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: eL 0!S /R L Intake Comments: PW Worksheet Needed 1: <br /> ❑Sys Dev Eval F raffic Mit Eval <br /> 5'4llP,../6CT -To ria-t_40 I me -r ❑Site Work or ► ainage Proposed <br /> Approved By: Date: 41Z4/i9 ❑Backflow °revention for high hazard: <br /> (dental,m:..ical,animals,mortuary,hospital, <br /> suppo ',e housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at - d ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separat concurrent PW Revie ( een Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder J Submitted Previou-% rA Deferred <br /> Additional Notes: 0 This Permit is Approve. .y Public Works <br /> 0 See PW Review W. sheet and associ. :• attached items <br /> Fire Dept. Fees: 0 A Separate PW ',-rmit is Required (' it#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is loc- -d in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is i r a Separate Green Folder(loin with this folder for permit issuance) <br /> O Review/Inspection Scope-ADD FIRE FEE 0 ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />