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Intake &Approval Sheet 40 (FOR PERMIT STAFF ONLY) • PERMIT;abaft <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <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 ❑ Hold in Planning File Draw/ <br /> Garage/Accessory Struct.Size Zone r, 1—Z. <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use ( ' 5Fg.. <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: 1 <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ` No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Am nt$ <br /> Fire Alarm: ❑Update Existing Chew System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credi . <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo chool Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: hret..peela`,. r`6'e "ti 0-- <br /> VALUATION CALCULATION: Total$ <br /> Approved By: IL:1 Date: •q—)—ug ze) <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: may, Intake Comments: <br /> FILE. l �-r�yt a p.n�.1 PW Worksheet Needed if: <br /> I❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> eV <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: Date: £ (�/��( (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ❑Route 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: `; ❑ This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑A Separate PW Permit is Required(Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: ElsRublic Works has no scope---PW Not Required <br /> Additional Notes: Q? bo /za.--Lis, <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />