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Intake &Approval Sheet (FOR PERMIT STAFF ONL19 PERMIT# fJ\V—UU� <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <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 Drawer <br /> Garage/Accessory Struct. Size Zone • <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <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 ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ONo <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <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 ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? Oyes ❑No Additional Notes: <br /> "-�t <br /> VALUATION CALCULATION: Total$ �t5tx <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PWWorksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> CI Site Work or Drainage Proposed <br /> Approved By: �' Date: 11140/($ ❑Backflow Prevention for high hazard: <br /> '� I / (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) ❑This 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 !A This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing New System ❑ Not Req'd ❑A Separate PW Permit is Required(Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System Not Req'd AND ❑ Is located in this folder <br /> Chemical Sup: ❑Update Existing El New System, Not Req'd ❑ Is in a Separate Green Folder Coin with this folder for permit issuance) <br /> Additional Notes: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: II/21/y ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL "Th gere..wcv /44 <br /> Additional Notes: <br /> Approved By: Date: Approved ate: /zeknos <br /> (Zip <br />