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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#CJtO"A ^C)03 <br /> BUILDING PLANNING <br /> Intake OK by: clit Date: 4/4/(9 Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> I -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 (63D S't 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone 1?•••-• <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No 0Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction 'r6 Residential Use zf K <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 tNo <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? ❑YesNo ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ESI{{No Additional Notes: <br /> VALUATION CALCULATION: Total$ «-7$ <br /> Approved By� —" Date:GtQL{_ <br /> PUBLIC WORKS <br /> Intake OK by: -71-1,1 Date: 4141/5 <br /> Additional Notes: Z.. /S• /2G /,(f t.- Intake Comments: PW Woorif: <br /> rkkssheet Needed <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> f."" ❑Site Work or Drainage Proposed 'ate <br /> Approved By: Date: 4/4/'? ❑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/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: 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: ❑A Separate PW Permit is Required (Permit#: PW <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> O Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> O Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: blic Works has no scope---PW Not -equired <br /> Additional Not _ — <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />