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Intake & Approval Sheet I* (FOR PERMIT STAFF ONLY) 0 PERMIT # ? 2002 0�4 <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />❑No ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System <br />❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System <br />❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes <br />❑ No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes <br />❑No <br />VALUATION CALCULATION: Total$2-7p02,5Gt; <br />rW F,- i Or <br />; <br />Additional Notes: <br />Approved Bye ;Y�e��/ Date: <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />❑Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />❑ Minimal or No Fire Scope - NO FIRE FEE <br />❑ Review / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: Date: <br />Intake Comments: <br />on I Car i` VZ, r <br />IG�44�2(NcvsC� '�c¢ Ch* '�e�j <br />❑ lach to Project No. iT <br />❑ Route to Historic Reviewer <br />® OK to Route to Other Departments <br />® Hold in Planning File Drawer <br />Zone <br />- <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />-. I 11A <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ;F]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 By: t� '. Date: <br />PUBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: =PW Worksheet Needed if• _.�_._.,...- <br />=0Sys Dev Eval ❑Traffic Mit Eva! <br />[]Site Work or Drainage Proposed <br />❑Backflow Prevention for high hazard: <br />:(dental, medical, animals, mortuary, hospital, <br />_supportive housing) <br />e......... _.......... .... .......... ..... ......,.,,..,......................_........ ........ ...... ............. ........ ................. <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 />❑ This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folderfor 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 />CF <br />