Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1S (gv"x <br /> BUILDING PLANNING <br /> Intake OK by: Date: II/ te'IS 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 0 Route to Historic Reviewer <br /> ❑ Make this a"W" Permit 0 OK to Route to Other Departments <br /> Bldg fl Addn/Rem Size 0 Hold in Planning File Drawer VON Garage/Accessory Struct.Size Zone V`/"\ <br /> Number of Stories Overlay/Agreement <br /> Basement ZNo ❑Yes , Fin/Unfin Nonresidential Use Nlolle <br /> Type of Construction V t3 Residential Use yiovve <br /> Occupancy Group U Proposed No.of Dwelling Units: f <br /> Occupancy Load — Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System I4Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: 9 t NVTFs 461-4"6// "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System taINot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: '5" `5'17°.` ~44a-l'es taw Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑Everett School Dist ❑Mukilteo School_ Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: —Nis �Jew ??s �S NPt e-S b�`s.\\.1�10cjk <br /> VALUATION CALCULATION: Total$ Sb, o06 "kkSQ., \p ;kckw et ' t� "� <br /> A\,,,& kk� ` c '3 <br /> Approved By( 'Z,f Date: l\.N.D. ZO\A' <br /> PUBLIC WORKS <br /> Intake OK by: _53 Date: /feetVt8 <br /> }t <br /> Additional Notes: "`I- 5 Ls 2 T(i-ps'P Z Intake Comment?: PW Works Needed if: �-Hi <br /> -naMp, S t+ekt+� cr Mpsp,Alty LAC.../AAA tLA.�[x� i ❑Sys Dev Eval ❑Traffic Mit Eval <br /> '(ur j'dj ( jc�/t.£ ❑Site Work or Drainage Proposed <br /> (c:f/Le, 7)8 tur PGII # ❑Backflow Prevention for high hazard: <br /> Approved By: Date: (` � � .lp,��j(i (dental,medical,animals,mortuary,hospital, <br /> �E-C,-E -€44 4� 0 supportive housing) <br /> FIRE DEPARTMENT gRoute 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 0 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 [hew 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 ❑ Is located in this folder <br /> Chemical Sup: ❑Updat Existing ❑re_New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: # --r-77 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: N Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ..,No EASfia 1'4 14ECISS4WI' of soR;Ac.f ooLt. - .N+ l?A«4pf <br /> ELECTRICAL ."'k -av,e-re. -rp -re-E - -21?-0W1-1 a c- W-Ii+4.-"r <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: 11/141/8 <br />