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Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLV) <br />PERMIT # <br />BUILDING <br />Intake OK by: Date: yJ <br />Intake Comment <br />El Route to Commercial Building <br />11 Route to Residential Building <br />El Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />2 1 <br />Garage/Accessory Struct. Size <br />-- <br />Number of Stories <br />Z <br />Basement <br />No Elyes <br />Fin Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: 19 Update Existing ❑New System <br />11 Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: R3 Update Existing ONew System <br />El Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ElYes ma J No <br />Add'I RCW 64.55 docs required prior to final? Elyes RNo <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />Approved By: 1�9E Date: aLrL1z62-,o <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />[]Fire Sprinklers E]FireAlarm 0Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />11 Review of As -Built Plans - NO FIRE FEE <br />El Minimal or No Fire Scope - NO FIRE FEE <br />11 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 />Vib ck <br />[I Attach to Project No. <br />El Route to Historic Reviewer <br />0 OK to Route to Other Departments <br />0 Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />(e <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? 11Yes [Tmo_ <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />DEverett School Dist E]Mukilteo School Dist <br />Additional Notes: Lzory- onlA — no -eY,4e-,ic-- <br />e,ia'a,d or � <br />1Approved B Date: Z - <br />� I <br />FGBLIG WORKS <br />Intake OK by: Date: <br />. . ............. . ........ -1.1 ....... . .......................... ... . ........ ........................... .................................. <br />Intake Comments: <br />PW Worksheet Needed if., <br />El Sys Dev Eval [JTraffic Mit Eval <br />Site Work or Drainage Proposed <br />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 />ElThis project also has a separate concurrent PW Review (Green Folder) <br />AND OCreate Green Folder [:]Submitted Previously []Deferred <br />❑ This Permit is Approved by Public Works <br />El See PW Review Worksheet and associated attached items <br />El A Separate PW Permit is Required (Permit #: PW <br />AND El 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 />LV Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: Date: <br />