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Intake & Approval Sheet 0 (FOR PERMIT STAFF ON09 • PERMIT # Z 1 qMJo ©2--- <br />BUILDING <br />Intake OK by::\ti Date:C . O Zo <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Ad em Siz <br />3 6�7 <br />Garage/Accessory Struct. Size <br />�,.d <br />Number of Stories <br />/ <br />Basement <br />❑No ❑Yes , Fin / Unfin <br />Type of Construction <br />t//3 <br />Occupancy Group <br />13 <br />Occupancy Load <br />37 <br />Fire Sprinklers: 1JUpdate Existing ❑New System Not Req'd <br />Reason Sprinklers Required: <br />rs� <br />Fire Alarm: 1�Update Existing ❑New System []NotReq'd <br />Reason Fire Alarm Required: <br />r <br />RCW 64.55 MF worksheet req'd for permit? ❑ ON No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes 2No <br />VALUATION CALCULATION: Total $ DOO, O'd <br />Additional Notes: <br />Approved By. Date: � 6' zojGQ <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />El Route to Fire Drawer --- Fire Preliminary Review Notice <br />El Sending Fire Notes to Project Team <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: Update Existing El New System R9 Not Req'd <br />Fire Alarm: .Update Existing 1ANew System r❑1 Not Req'd <br />Chemical Sup: 7Update Existing ❑New System IJ Not Req'd <br />Additional Notes: <br />Approved By:G1 / Date: - Z -? - <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by `� Date: <br />Intake Comments: Assign To: % <br />Attach to Project No. /" "o! O <br />❑ ute to Historic Reviewer <br />l� OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />00 <br />Zone <br />- <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />---' <br />Proposed No. of Dwelling Units:r— <br />Total No. of Dwelling Units: <br />-----�" <br />Planning/Landscape Inspection Required before Final? <br />Yes ❑No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist. <br />Additional Notes: <br />Approved B . Date: <br />PUBLIC WORKS <br />Intake OK by: -T-ci.a Date: + 1 <br />Intake Comments: ;PWWorksheet Needed if. <br />• <br />YZ�v�.gca w i. JCS Sf : ❑Sys Dev Eva] ❑Traffic Mit Eva[ <br />®site Work or Drainage Proposed <br />Of- 1?A-A%*j[q 1FN Crtr►rst <br />❑Backflow Prevention for high hazard: <br />40 C M"&%C o G v$ f, (dental, medical, animals, mortuary, hospital, <br />f�Q- sYi p{-�, ;supportive housing) <br />®Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />IR This Permit is Approved by Public Works <br />IR-See PW Review Worksheet and associated attached items <br />2 A Separate PW Permit is Required (Permit #: PW (60'7- 01,E ) <br />AND +Q Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folder for permit issuance) <br />❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: Date: <br />