Laserfiche WebLink
`Rod -OS <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#S <br /> BUILDING PLANNING <br /> Intake OK by: Date: 8/�r(� Intake 0 'y: Date: <br /> Intake Comment . 1 Intake Comme,ts: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Revie :r <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Depa ents <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size - Zone <br /> Number of Stories i-- Overlay/Agreement <br /> Basement ONo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> 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 ''nal? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System L"1Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes gl No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 dots required prior to final? ❑Yes ®No Additional Notes: <br /> VALUATION CALCULATION: Total$ 25 r2-,,,2, <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake sK by: Date: <br /> Additional Notes: ;,i., 'I r nt s +SAP - of Intake Co , ents: PW Worksheet Needed if: <br /> -t-t- M 4.(4-2 crF. "F-6,-Ms.s ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: f(or Date: \o/4/liq ❑Backflow Prevention for high hazard: <br /> i (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW R- iew at end ---PIN Review Worksheet <br /> Se..rate/Deferred Submittals Required: ❑This project also has a separa concurrent PW Review(Green Folder) <br /> ❑Fir- Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Su:q itted Previously ❑Deferred <br /> Additional otes: ❑This Permit is Approved by Public W. s <br /> ❑ See PW Review Worksheet and associa-d attached items <br /> Fire Dept. Fees: 0 A Separate PW Permit is Required(Permit '. PW ) <br /> ❑ Review of As-Built • :ns-NO FIRE FEE AND ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scop- -NO FIRE FEE 0 Is in a Separate Green Folder(join with this fold- for permit issuance) <br /> ❑ Review/Inspection Scope- = ID FIRE FEE 0 Will be issued separately(Separate Green Folder,P N .ssued ahead of Bldg) <br /> Approved By: c I.te: ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />