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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# fu✓, i4'-1'i' j <br /> BUILDING PLANNING <br /> Intake OK by: Date: 5/267/15 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 ❑ 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 S-14 S r Zone K-2 <br /> Number of Stories 1 Overlay/Agreement <br /> Basement (AINo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use ;\-G.(, SF(Z-_- <br /> Occupancy Group v\ Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: i <br /> Fire Sprinklers: ❑Update Existing ❑New System 'lot Req'd Planning/Landscape Inspection Required before Final? ❑Yes gNo <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ONew System Zot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes NI No DEverett School Dist ❑Mukilteo School ' t <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes 1 :1No Additional Notes: <br /> VALUATION CALCULATION: Total$ 2C,V 6 <br /> Approved By: ICC Date: 9---z_t.-i< <br /> UBLIC WORKSq <br /> Intake OK by:C Date: 6(�� g <br /> Additional Notes: /S' /26 Intake Comments: PW Worksheet Needed if: ,P E <br /> I/ <br /> 6I �# , ❑Sys Dev Eval ❑Traffic Mit Eval <br /> AU`�j� , � /0 ��� 4-DSite Work or Drainage Proposed <br /> �%�r"" 10Q4— <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: -7 Date: / j n S <br /> �� 6 TOr pls'� p(S.JJJ666 (dental,medical,animals,mortuary,hospital, <br /> 46_,....,r,„ Cg_„Lr,,,,/ 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 Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team kA This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND ® r n0'TGS On Ssi'le--p64'► . " <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issua ) <br /> Additional Notes: ❑ 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 /> Addi 'ona Notes: <br /> ELECTRICAL OK' sr \ 1,, /iJ <br /> Additional Notes: '�, r / 2,/-2_, 7 <br /> Approved By: Date: A.a roved By: Date: <br />