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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# b gll r 0 ,3 <br /> BUILDING PLANNING <br /> Intake OK by: e Date: 18 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 Amp e-64400 - 0 OK to Route to Other Departments <br /> Bldg/Tler tem Size 43,C$:r. 1""�r $ 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone g—I <br /> Number of Stories Overlay/Agreement <br /> Basement No DYes, Fin/Unfin Nonresidential Use <br /> Type of Construction 3 Residential Use /V)\\-- . -61{P1.1) 4 °. <br /> Occupancy Group 1Z/L4 Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes)KINo <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: rbf Calculated: Credi • <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes aF No El Everett School Dist ❑Mukilt School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes IRINo Additional Notes: c'i s e.6-1k <br /> VALUATION CALCULATION: Total$ 66.536 <br /> h1f✓Af� 'oC6g7 AXE 80 5g <br /> �� Coi J Approved By: ,, Date: <br /> 16 'ro 1-4vi 26,14 .5711 V`e,t fiQ2.4 <br /> 4:1 <br /> k 0P171 o,J 70 z'r12 3640 le UBLIC WORKS <br /> Intake OK by: V /NJ Date: 1 I '21 J so lb <br /> Additional Notes: 00/$ /'ez., WSiEG Intake Comments: PW Worksheet Needed if:: <br /> 12,c I Aam-r ars c.c lf ❑Sys Dev Eval ❑Traffic Mit Eval <br /> Cow vE.a.SIo*• r• DSite Work or Drainage Proposed <br /> nwn..-r 'FARA%%-.e 141..44 ❑Backflow Prevention for high hazard: <br /> Approved By: Date: <br /> +�►� 1,40:E.S -ro mar„ (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT -oute 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 !ri,_ his Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) • 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 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder Goin with this folder for permit issuance) <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 /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved — - - ■ate: ,Z,t�sf,2or� <br /> 2 a/z3%-,r1 <br />