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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# b\46i,06 ®3 b <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 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`l) its: <br /> Occupancy Load Total No. of Dwelling its: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landsc- se Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee: T-pe: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Imp ct Fee: Total $ <br /> Reason Fire Alarm Required: Calcula •d: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Ads tional Notes: <br /> VALUATION CALCULATION: Total$ • <br /> VI Of <br /> Approved By: '' Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Neede. <br /> ❑Sys Dev Eval '4 Traffic Mit Eval <br /> ❑Site Work• Irainage Proposed <br /> vrc <br /> Approved By: Date: /��/�� ❑Backfl., Prevention for high hazard: <br /> (dental edical,animals,mortuary,hospital, <br /> sup•.rtive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a sepa : e concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Fold: ❑Submitted Previously ❑Deferred <br /> Additional Notes: ElElThis Permit is Appr.ied by Public Works <br /> J/Lj4 /1. See PW Revie orksheet and associated attached items <br /> Fire De . F s: I ❑A Separate ' Permit is Required (Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ - located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE S. Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: r®(ocd sfl Date: 4; i Sl Public Works has no scope---PW Not Required <br /> J Additional Notes: <br /> ELECTRICAL. �b1 , l <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />