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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT#-99-k o` VC6. <br /> 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 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> A G`Q tOO 'P 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size - Zone 6 <br /> Number of Stories / Omer-lay rr>ent Scz 22\ i_S7S-AS.— [' <br /> Basement ravo ❑Yes, Fin/Unfin Nonresidential Use Qt e c 'c.Q. ,, t <br /> . Type of Construction Residential Use <br /> Occupancy Group S8 Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ONew System IGlNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes I'=)No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: CI Update Existing ONew System pNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes r® No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes -No Additional Notes: <br /> VALUATION CALCULATION: Total$ / DOD. 0 <br /> Approved B Date: \2-c.v-\ <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: c/a sz4Jce ax./Z.Y Intake Comments: 1PW Worksheet Needed if: <br /> I DSys Dev Eval OTraffic Mit Eval <br /> I El Site Work or Drainage Proposed <br /> 64 <br /> Approved By. Date: I <br /> DBackflow 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 /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑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 coin with this folder for permit issuance) <br /> Review/Inspection Scope-ADD FIRE FEE f 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: i4„16Q,UpA. Date: -''21 y2.Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Ali Date: if IN <br />