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Intake & Approval Sheet <br />*(FOR PERMIT STAFF ON09 & PERMIT # & <br />BUILDING <br />Intake OK by: Date:��_�_� d <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ M,ake this a "W" Permit <br />Bld I/ ddn/Rem Size <br />T 9 7 % <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />❑No ElYes , Fin / Unfin <br />Type of Construction <br />r,3 <br />Occupancy Group <br />4— <br />Occupancy Load <br />2-6�i <br />Fire Sprinklers: Update Existing ❑New System El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: RUpdate Existing ❑New System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes 2 No <br />Add'] RCW 64.55 docs required prior to final? ❑Yes ®No <br />VALUATION CALCULATION: Total $60, of <br />Additional Notes: <br />Approved By Date: <br />V <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑ Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team <br />Date: 'I a s" 13 (OK to Route to Other Departments) <br />Fire Sprinklers: ❑Update Existing ❑New System ❑ Not Req'd <br />Fire Alarm: ❑'CJpdate Existing ❑New System ❑ Not Req'd <br />Chemical Sup: DUpdate Existing El New System ® Not Req'd <br />Additional Notes: <br />Approved By: e # Date: 9'- ZS' / £� <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by Date: d <br />Intake Comments: Assign To: <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 />1 N <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ®No <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 />`(\c <br />tPtaS;kOA <br />Approved By: Date: Cl\ Ao\ \`�— <br />PUBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: ;PW Worksheet Needed if.- <br />C ; ❑Sys Dev Eval ❑Traffic Mit Eval <br />: ❑Site Work or Drainage Proposed <br />❑Backf]ow Prevention for high hazard: <br />:(dental, medical, animals, mortuary, hospital, <br />.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 />❑ 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 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 <br />Notes: <br />ea <br />Ko GIIAa�4�" �' USE �SrL�lA++r 'ib p� <br />Date: H /2 9 /Zo/8 <br />