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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments:' Intake Comments: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem SizePlanning <br /> 0 <br /> Hold in File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No Dyes Fin/Unfin Nonresidential Use N. <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System Mot Req'd Planning/Landscape Inspection Required be •re Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amok t$ <br /> Fire Alarm: ❑Update 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 ❑ No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ONo Additional Notes: <br /> VALUATION CALCULATION: Total$ ,Q <br /> :x/A/zc / N /ZEv,TE. <br /> ,ryj:/(10( Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> o o,grrc copy C6.I447P'iO , <br /> : Sys Dev Eval ❑Traffic Mit Eval <br /> €DSite Work or Drainage Proposed <br /> Approved B�✓=- Date: QZ 2'6��� �Backflow Prevention for high hazard: <br /> / i(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for P 'eview at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a sepa .te concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm DOther: AND ❑Create Green Folder ❑ .bmitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public ' irks <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 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("loin with this fol.-r for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,P, issued ahead of Bldg) <br /> Approved B `\ "��4.- Date: �j z/-*/p?.m ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL • <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />