Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# D A (..)(1"/ 3 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: \."---r- Date: ( <br /> Intake Comments: Intake Comments: Assign To: GL H <br /> e fore e 5 <br /> Oo .e. � � 1-1P00 CP <br /> ElRoute to Commercial Building ❑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 <br /> Garage/Accessory Struct. Size Zone '(Z,-Z,,, T <br /> Number of Stories Overlay/Agreement 1- <br /> Basement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <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 10 <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amoun <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Cr : <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mu ' eo School Dist <br /> Add'!RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: Coo( r n. b -05 <br /> VALUATION CALCULATION: Total v-N <br /> 1Te— 3160( ff vC. <br /> Approved_ By: IL (/ Date: ' q-)' <br /> PUBLIC WORKS <br /> i _Intake OK by- Date_................ <br /> Additional Notes: tpet,4 r,>`cT‘ca).4 ent.SL�C a Intake Comments: PW Worksheet Needed if: <br /> 170 1 ©.r e rn, d ❑Sys Dev Eval ❑Traffic Mit Eval <br /> W ❑Site Work or Drainage Proposed <br /> Approved By: Al Date: 8 rtOl 11" 1 .21--inn f DBackflow Prevention for high hazard: <br /> 0 2s /II le• (dental,medical,animals,mortuary,hospital, <br /> n O au Silz. tnip€,C6i. supportive housing) <br /> FIRE DEPARTMENT DRoute 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 OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: It This Permit is Approved by Public Works <br /> ❑ 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(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: 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 />