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Intake &Approval Sheet • (FOR PERMIT STAFF ONLI° • PERMIT# 0 kS ,(2--0(2 <br /> BUILDING PLANNING <br /> Intake OK by: O l' Date: l214 //3Intake OK by: C Date: 2-• 2_1• Z0\ <br /> Intake Comments: 1 Intake Comments: Assign To: ,coit ,__ S; <br /> i-v f\oc \ek i, o,,n C9•rrec-\\:w cto . <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> IRRoute to Residential Building ❑ Route to Historic Reviewer <br /> 0 Make this a"W" Permit �ii OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 46 _ $ ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size O s: Zone 'i•.— <br /> Number of Stories Z Overlay/Agreement <br /> Basement CEINo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction V F Residential Use ,N-ex <br /> 2 W Occupancy Group gAt Proposed No. of Dwelling Units: E Or— <br /> Occupancy Load Total No. of Dwelling Units: 2.. <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before inal? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amou t$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ 1 d (15 <br /> Reason Fire Alarm Required: Calculated: Are-1 L/C)_p° Credit: NJ j \�,.`� <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes wiNo ®Everett School Dist ❑Mukilteo School Dist ��'�' <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes &rNo Additional Notes: <br /> VALUATION CALCULATION: Total$ 5-e71.729- <br /> Approved B J Date: Co,`a,ao\L <br /> PUBLIC WORKS <br /> Intake OK by: Date: 12121 28fX" <br /> Additional Notes: Zea-- ' S"gC. Intake Comments: <br /> PW Worksheet Needed if: <br /> q „, /Sys Dev Eval Traffic Mit Eval <br /> t ,�,ISite Work or Drainage Proposed <br /> pp By: Date: ❑Backflow Prevention for high hazard: <br /> Approved l�lZ1i//�� (dental,medical,animals,mortuary,hospital, <br /> `( I` supportive housing) <br /> FIRE DEPARTMENT gRoute this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) his 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 p This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System rDa Not Req'd ElA Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ❑New System ILtI Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System ID Not Req'd// ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: /�le(9Yt`fi 5t�h w� 17i ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:C7�n Date: ti/2 SI/�f ❑ Public Works has no scope---PW Not Required <br /> 11I // // Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: 1/0 Date: /0 <br />