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Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLr 0 PERMIT #S`" ` 2D <br />BUILDING <br />Intake OK by: Date: <br />Intake Comme s: <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 />V'Pe <br />Occupancy Group <br />Occupancy Load <br />4- <br />Fire Sprinklers: gD Update Existing ❑New System El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: 1Z Update Existing ❑New System ❑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 />R� <br />M No <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />Approved By: Date: <br />IRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El 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: � jn Date: 1,2, <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: Date: <br />Intake Comments: <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 />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 />❑Everett School Dist Mukilteo School Dist <br />Additional Notes: <br />Appr ed Date: <br />PUPMP <br />WORKS <br />take OK by: ,......._......................... <br />: ___..._......._..........,. ........................................................_ <br />• <br />Intake Comments: New vsE lAn T.%,'PW Worksheet Needed if. <br />�Vj�, vt►ir10r Siff UtEYL % ►�1nWE 0Sys Dev Eval Traffic Mit Eval f�Fn <br />q S CEs art C+'> e: ciVb�- <br />!(Site Work Drainage Proposed <br />or <br />Wlgomp. ,�J� DraFrta memo <br />Wackflow Prevention for high hazard: <br />incluarj. !o7 ;(dental medic animals, mortuary, hospital T�' <br />b lCk��DW isupportiveTiousing)L� ULI "I <br />- <br />.....................................................-.... ........ u. <br />WrR'oute <br />this folder for PW Review at end --- PW Review Worksheet <br />This project also has a separate concurrent PW Review (Green Folder) <br />A Create Green Folder ❑Submitted Previously ❑Deferred <br />❑ Thl it 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 Qoin 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 Notes: <br />V �✓ �� ' <br />Approved By: Date: <br />FMr <br />