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• 410 <br /> Intake 4 Approval Sheet (FOP!' PEF!•MIT STAFF ONLY) PERMIT#3)2001 <br /> • Lz U1LDING PLANNING _ <br /> Intake OK by: Date: • Intake OK by: Assign To: Date: <br /> Intake Comments: • Intake Comments: <br /> . . <br /> 0 Route to Commercial Building 0 Attach to Project No. <br /> El Route to Residential Building 0 Route to Historic Reviewer <br /> El Make this a"W"Permit • El OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer __ _______ <br /> Garage/AcceSsory Struct.-Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement EINo DYes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> ----- Occupancy Group -----•----- -- Proposed No..pf.Dwelling Units- __ _ _._ _ . . <br /> Occupancy Load • Total No.of Dwelling Units: <br /> Fire Sprinklers: ['Update Existing ONew System ['Not Req'd Planning/Landscape Inspection Required before Final? DYes EINo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: DUpdate Existing EINew System 0Not Req'd 'School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? Dyes. 0 No ElEverett School Dist EIMukilteo SchOol Dist <br /> • Add'I RCW 64.55 does required prior to final? [hies EINo Additional Notes: <br /> • VALUATION CALCULATION: Total$ <br /> • , fi 0 CiAciiv?/ -')A6-4- retkd ity4 .. <br /> • Approved By: ' D te:6 fte) <br /> ... <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: - Intake Comments: i <br /> i PW Worksheet Needed if: <br /> . 1_ <br /> - . ELISys Dev Eval DTraffic Mit Eval <br /> lEISite Work or Drainage P ..osed <br /> i . <br /> !Approved By: Date: 1141mA 0 Backflow Preventi• for high hazard: <br /> I(dental,medical,a " als,mortuary,hospital, <br /> If 2 <br /> !supportive hou ' g) <br /> I <br /> FIRE DEPARTMENT ORoute this folder for PW Review at end -PW Review Worksheet <br /> , " -• <br /> Separate/Deferred Submittals Required: EiThis project also has a separate co' urrent PW Review(Green Folder) <br /> OFire Sprinklers OFire Alarm ElOther: ,AND EICreate Green Folder .11 ubmitted Previously EiDeferred <br /> Additional Notes: ) 0 This Permit is Approved 0 Public Works . <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 /> ,El Review of As-Built Plans-NO FIRE FEE AND El Is lo :ted in this folder <br /> 0 Minimal or No Fire Scope-NO FIRE FEE 0 Is' a Separate Green Folder(join with this folder for permit issuance) <br /> 0 Review/Inspection Scope-ADD FIRE FEE II ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Pate: !$ Public Works has no scope---PW Not Required <br /> ,To ditional Notes: <br /> ELECTRICAL <br /> Additional Notes: • <br /> Approved By: Date: Approved By: Date: <br /> . . <br /> 242-- <br />