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• r <br /> !Make t A,rprroval Sheet (Mr- PEi EMIT STAFF ONLY) PERMIT# f72 s, 1,Olt <br /> I =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 - El OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size El Hold in Planning File Drawer <br /> Garage/Accessory Struct:Size Zone -- - <br /> Number of Stories Overlay/Agreement <br /> Basement Cho ®Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> - _ <br /> Proposed No. ._ ____---. —. _. _—_ __--- <br /> - --:- Qccupaney Group -�_ _ _ :. - . . <br /> ----.__ ..- p g.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 ®No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ®Update Existing ONew 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? Oyes. ® No ®Everett School Dist ®Mukilteo School Dist <br /> iAdd'I RCW 64.55 does required prior to final? ®Yes ®No 'Additional Notes: <br /> VALUATION CALCULATION: Total <br /> - fit CCACIA \ok f\etik61• Approved By: VI <br /> D tea o e tt(� <br /> g, , <br /> PUBLIC WORKS <br /> 'Intake OK by: Date: <br /> Additional Notes: - Intake Comments: =PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage P ..osed <br /> Approved By: Date: iit '❑Backflow Preventi. for high hazard: <br /> =(dental,medical,a ' ais,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 a" ubmitted Previously EIDeferred <br /> Additional Notes: 3 El This Permit is Approved e Public Works 'CI - <br /> 0 See PW Review W. sheet and associated attached items <br /> Fire Dept.Fees: El A Separate PW 'ermit is Required (Permit#: PW ) <br /> ® Review of As-Built Plans-NO FIRE FEE AND El Is located in this folder <br /> Minimal or No Fire Scope-NO FIRE FEE 0 Is" a Separate Green Folder(join with this folder for permit issuance) <br /> ® Review/Inspection Scope-ADD FIRE FEE III ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: . Date: LTS Public Works has no scope---PW Not Required <br /> rt,.itional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: . Date: <br /> 3/� <br />