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Intake & Approval Sheet <br />0 <br />F(aif" PERMIT .S l.' STAFF �IJ; JI r` ■'i i':.i :� • <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 ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? []Yes ® No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes []No <br />VALUATION CALCULATION: Total $ OGO2,5-01(% ; <br />f r <br />-014, EZ a;�r G z-,X , <br />Additional Notes: <br />Approved By ti' i/l Date: C)Z17-JILO .a <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 />,�s <br />p <br />1 d €� s <br />® Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />it1.a d T�- C.M I LA <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ;MNo <br />"in Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />El Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: <br />Approved By: �� Date: <br />PUBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: -PW Worksheet Needed if.• <br />l_lSys Dev Eval l]Traffic Mit Eval <br />=l�Site Work or Drainage Proposed <br />I El Backflow Prevention for high hazard: <br />`(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />. ........................................_................_....-......................,,...,..................... <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 />w1... <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 />