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).3(.4 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# !J D/1".° <br /> /y� BUILDING PLANNING <br /> Intake OK b s l /L Date: 7`Z-S/ 0/? Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> El 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 /> BldgITl/Addn/Rem Size 2'a S 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size — Zone Zone — <br /> Number of Stories Overlay/Agreement <br /> Basement 111No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction \l $ Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load moi' Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System lnNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System tuNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes P No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes E No Additional�a 'Notes: O L�+`� :A lOw_ <br /> VALUATION CALCULATION: Total$ !fib a et" AV:45r�� <br /> Approved By: j/_. ,,J\r‘ Date: --7_2c�-)°( <br /> C� <br /> PUBLIC WORKS <br /> Intake OK by: T 0.1 Date: —7 J25 /Zo 19 <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> 'EAa 6nff- ❑Sys Dev Eval ❑Traffic Mit Eval <br /> 'Dao DSite Work or Drainage Proposed <br /> qLE-S--c ��� €1..s-c ❑Backflow Prevention for high hazard: <br /> Approved By: ; Date: 'q-12 r,:;,/141 <br /> Wen.* (dental,medical,animals,mortuary,hospital, <br /> a-% supportive housing) <br /> FIRE DEPARTMENT tVRoute 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes' Phis Permit is Approved by Public Works <br /> l bT re V",O&) 0 See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: 0 A Separate PW Permit is Required (Permit#: PW <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder Uoin with this lolderfor permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will 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 /> Ei ) <br />