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Intake & Approval Sheet 9 (FOR PERMIT STAFF ONLr * PERMIT #7�O � %2—, ©J <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 $ <br />Additional Notes: <br />Approved By: Date: <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />❑Fire Sprinklers []FireAlarm ❑Other: <br />.A <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 />tg*k <br />❑ Att rt No. <br />® Rout 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 />- -- <br />Planning/Landscape Inspection Required before Final? ❑Yes El 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: Date: <br />PUM WORKS �Ovi i <br />Intake OK by: e j . .Date: P Z l6 ZO/?. ...................... <br />Intake Comments: N Fw uz jin =PW Worksheet Needed if., <br />yi1it10Y sils k "OSys Dev Eva1 Traffic Mit Eva[ t, nu <br />q s v � cv dly-�6�� <br />=14Site Work or Drainage Proposed <br />k -+ faviy'Dnma�t memo <br />%o} Uackflow Prevention for high hazard: <br />IyYy1�e�UdF-d-/ �L J (dental medic animals, �m^ortuaryl, hos ital, F <br />WrRoute <br />�IGiC�f�OIV'supportive ousing DL-A rf>;ASiAo.........._..........................................�..........-.......�1.� . tn47fl1�t...,.o.fi'2-M <br />this folder for PW Review at end --- PWReview Worksheef <br />This roject also has a separate concurrent PW Review (Green Folder) <br />AND Mcreate Green Folder ❑Submitted Previously ❑Deferred <br />This Permit is Approved by Public Works <br />M-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 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: OZ 26 Lb <br />S <br />