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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# <br /> � <br /> BUILDING PLANNING <br /> Intake OK by: I^Ov'. �f/ Date: Intake OK by:1bv\'LQt, Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> 0 Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Ma.- this a"W" Permit 0 OK to Route to Other Departments <br /> c <br /> BI•g/TI/•ddn/Rem Size ,S730 21) 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size // Zone <br /> Number of Stories Overlay/Agreement <br /> Basement EINo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group `02 Proposed No. of Dwelling Units: <br /> Occupancy Load � Total No. of Dwelling Units: <br /> Fire Sprinklers: MUpdate Existing ENew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: 12Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes .NNo ❑Everett School Dist DMukilteo School Dist <br /> ❑ 1 <br /> Add'I RCW 64.55 docs required prior to final? <br /> Yes ZI1 No Additional Notes: <br /> VALUATION CALCULATION: Total $ 3/ 4'/G'f ,j 31- ` /I <br /> Approved By: 1 061 l.J-i Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval DTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: ��S Date: 6444C ❑Backflow Prevention for high hazard: <br /> 7 1 (dental,medical,animals,mortuary,hospital, <br /> 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 /> DFire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 This Permit is Approved by Public Works <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: l ❑ A Separate PW Permit is Required (Permit#: PW <br /> El Review of As-Built Plans-NO FIRE FEE v �s� AND 0 Is located in this folder <br /> m <br /> ® Minimal or No Fire Scope- NO FIRE FEE' ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> 0 Review/Inspection Scope-ADD FIRE FEE n 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: �. tINVA Date: \ )o\•Lt A 0 Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL `n O� � , <br /> Additional Notes: 1 ` ' <br /> Approved By: Date: Approved By: TO v\ v / Date: <br />