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• <br /> • • <br /> Intake zk Approval She t (FOR PERMIT STAFF ONLY) PERMIT eV-Opt-on <br /> ,UILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: _. Date: <br /> Intake Comments: Intake Comments: <br /> 0 Route to Commercial Building ® Attach to Project No. <br /> ® Route to Residential Building ® Route to Historic Reviewer <br /> • <br /> El Make this a"W"Permit OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ® Hold in Planning File Drawer <br /> - -g ry Stud; - <br /> Gara e/Accesso -Si ----_ ---- - .Zone ---- ------ <br /> Number of Stories Overlay/Agreement <br /> • <br /> Basement ®No DYes, Fin/Unfin Nonresidential Use <br /> (Type of Construction Residential Use <br /> -_I 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? DYes II <br /> No <br /> I 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 /> I RCW 64.55 MF worksheet req'd for permit? DYes ® No ®Everett School Dist ElMukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ®Yes ®No Additional Notes: <br /> ;'VALUATION CALCULATION: Total$ <br /> J6-11Ok :\e,,,,0 w - <br /> • ;Approved By: [Ate:o' Cb\ <br /> , . <br /> PUBLIC WORKS <br /> Intake OK by: Date: . _ <br /> Additional Notes: - • intake Comments: IPW Worksheet Needed if: <br /> •- - DSys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage P ..osed <br /> !Approved By: roe! Date: 2Q ClBackflow Prevent!, for high hazard: <br /> :(dental,medical,a • als,mortuary,hospital, <br /> _supportive hou ' g) <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 co• urrent PW Review(Green Folder) <br /> ®Fire Sprinklers ®Fire Alarm ®Other: AND ®Create Green Folder I'" ubmitted Previously ®Deferred <br /> Additional Notes: This Permit is Approved . Public Works <br /> 0 See PW Review W. sheet and associated attached items <br /> Fire Dept.Fees: 0 A Separate PW 'ermit 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 El Is' a Separate Green Folder(loin with this folder for permit issuance) <br /> ® Review/Inspection Scope-ADD FIRE FEE . '' ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: - Date: Public Works has no scope---PW Not Required <br /> ditional Notes: <br /> ELECTRICAL <br /> Additional Notes: . <br /> Approved By: Date: Approved By: _ Date: <br />