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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) . PERMIT# (11.`QO2-0 l 0 <br /> BUILDING.. PLANNING talc). <br /> Intake OK by: d-14 Date: 2 1 i //t ' Intake OK by: � P Date: ' i(�•Q` � <br /> Intake Comments: Intake Comments: Assign To: % 0iV�J�' <br /> S� poi c� c % @ c <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> IStRoute 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 '3? ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size .. Zone c(' <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No INEYes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use S � <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 Final? ■ lid No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: A •- <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 1RNo El Everett Scho. % st ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? DYes 'No Additions Notes: <br /> VALUATION CALCULATION: Total$ &Ot 049 <br /> 2't® 73 4c ` <br /> �'��� Approved Br Date: V,1 \� \q <br /> PUBLIC WORKS _:_.. <br /> Intake OK by: Date: <br /> Additional Notes: 2_D ��" lAC <br /> Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> / ❑Backflow Prevention for high hazard: <br /> Approved By: Date: 3l � I tct (dental,medical,animals,mortuary,hospital, <br /> �.IikEti:iEPARrMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team ❑This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑ Not Req'd ❑A Separate PW Permit is Required(Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd AND ❑ Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System ❑ Not Req'd ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: <br /> ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> ❑ ADD FIRE FEE ❑ NO FIRE FEE jrPublic Works has no scope---PW Not Required <br /> Approved By: Date: Additional Notes: <br /> ELECTRICAL. :' <br /> Additional Notes: <br /> Approved By: Date: Approved By: a--- ' V tN Date: 2 I <br />