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Intake : 1ppmval Sheet (F F'' PE' ',IT STAFF •' 'LLY) • PERMIT#C 10 0 t V tc9 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> 0 ake Comments: Intake Comments: Assign To: <br /> ® Route to Commercial Building Ig Attach to Project No. u-17. 14` ov 2.-- <br /> ® Route to Residential Building ® Route to Historic Reviewer <br /> ® Make this a"W"Permit ® OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 2-'``.5'9 4 'ElHold in Planning File Drawer <br /> Garage/Accessory Stud,Size "il`1 0 Zone `iV-� <br /> Number of Stories Overlay/Agreement FQ0 <br /> Basement 154No ®Yes , Fin/Unfin Nonresidential Use <br /> 'Type of Construction Nlib ;Residential Use . . (2v <br /> Occupancy Group !,`Lk Proposed No. of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: ' <br /> Fire Sprinklers: ®U date Existing :New System ®Not Req'd Planning/Landscape Inspection Required before Final? ®Yes IJNo <br /> 1 p p <br /> !Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ®Update Existing ®New System ®Not Req'd School Impact Fee: Total $____TCA:j . <br /> I Reason Fire Alarm Required: Calculated: redit: <br /> RCW 64.55 MF worksheet req'd for permit? ®Yes 0 No ®Everett School Dist ®Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No lAdditional Notes: <br /> VALUATION CALCULATION: Total$ ' w,2 of OO 1 <br /> • TN 5 lab i vo6c) , <br /> (Approved By: Date: 'I l 1/cl <br /> PUBLIC WORKS <br /> ,Intake OK by: Date: 1 <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> - ❑Site Work or Drainage Proposed <br /> _ I ❑Backflow Prevention for high hazard: <br /> Approved By: Date: 7/i(on 9 1 (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ®Route this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) I®This project also has a separate concurrent PW Review(Green Folder) <br /> El Route to Fire Drawer---Fire Preliminary Review Notice AND ®Create Green Folder ®Submitted Previously ®Deferred <br /> ®Sending Fire Notes to Project Team i ! This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) i 72 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ®Update Existing ®New System ® Not Req'd j 2/A Separate PW Permit is Required (Permit#: PW L L cl--O'q ) <br /> Fire Alarm: ®Update Existing ®New System 0 Not Req'd ' AND ! Is located in this folder <br /> Chemical Sup: ®Update Existing ®New System 0 Not Req'd ® Is in a Separate Green Folder Qoin 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 /> i Additional Notes: <br /> 111, <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: ..)SE Date: 7-1 1 1 <br />