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ib611)vf I 1 I002_ n <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) . PERMIT# C (at,04-6 t l <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> ake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building �❑ oute to Historic Reviewer <br /> ❑ Make this a"W"Permit Lam+! OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size .1) Q( 'Z t 0 Hold in Planning File Drawer <br /> x <br /> Garage/Accessory•Struct.Size Sql 0 Zone IN G <br /> Number of Stories 2, Overlay/Agreement tV' <br /> Basement lANo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use cJ <br /> Occupancy Group 1 tiL Proposed No. of Dwelling Units: t <br /> Occupancy Load Total No. of Dwelling Units: t ,,__,,(( <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes V No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ aitnot ./ <br /> Reason Fire Alarm Required: Calculated: Credit: 1 <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes "-❑No Additional Notes:— <br /> 1 LUATION CALCULATION: Total$ 61--1 (0®•oo <br /> 9,015 ) ,k Approved B • / Date: / j / <br /> i b <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: zG� ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT El 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 RThis Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 2See PW Review Worksheet and associated attachedeitems <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 'CA Separate PW Permit is Required(Permit#:PW �9Oj-054 ) <br /> I <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND _fils located in this folder <br /> Chemical Sup: ❑Update Existing 0 New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> =proved By: Date: ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: i• Date: 1/25/7oi <br />