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(1048 ) C *8) _ 4311 4- <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# cif)1c)kO 2 OO`2j <br /> BUILDING PLANNING <br /> Intake OK by: I' Date: ( Q 11 19 Intake OK by: Date: <br /> Intake Comme i 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 /> O Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/Tl/Addn/Rem Size 8 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone PR---.5 <br /> Number of Stories -L. Overlay/Agreement <br /> Basement ktElNo ❑Yes, Fin 1 Unfin Nonresidential Use <br /> Type of Construction \/" .. Residential Use yvvU\\'i \-O. 0NA-) <br /> Occupancy Group V Proposed No.of Dwelling Units: <br /> Occupancy Load S Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes EGo <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 g No ❑Everett School Dist ❑Mukilte chool Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes WNo Additional Notes: li�C di _I v C6rbl+-- <br /> VALUATION CALCULATION: Total$ 3 I, 104 t1;k - - � (3'- i Q � 1 cA`Narn fel_ ?i, p(t,, <br /> Approved By: K.- tl Date: –,/ —1 CI <br /> PUBLIC WORKS a <br /> Intake OK by: r)1U E- Date: i2 //' o8 <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> "illr 170 ❑Sys Dev Eval ❑Traffic Mit Eval <br /> �� Y�` ❑Site Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: Date: 212c,(1,:T <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,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary R= few Notice AND OCreate Green Folder ❑Submitted Previously ODeferred <br /> ❑Sendin• ire Notes to Project Team 0 This Permit is Approved by Public Works <br /> Date: (OK to '.• e to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update - I '-• ■New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ■ -.date Existing ❑New Sys e II Not Req'd AND 0 Is located in this folder <br /> Chemical S •Update Existing ❑New System ❑ Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additi••.I Notes:IV* Yviti ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: '"'1111 '1 Date: Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By:r_ Date: /Z2.1/20/7 <br />