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Intake & Approval Sheet 16 (FOR PERMIT STAFF ONLY) 10 PERMIT # VZUD-60.3 <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 />— <br />Number of Stories <br />Basement <br />MNo ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />M <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 IgNo <br />VALUATION CALCULATION: Total $ 40 e,,Pv <br />Additional Notes: KAGw_1N(1 AWC_ cvKcrr_ p,,►t% <br />5TZ*AtgS KAG+i tis,"DAi �� <br />Approved By: Date: j I42a2t <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 />aReview / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: 11-3 <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: tq U)K/i Date: IU Z^% 126 <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 />C— <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />— <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />---- <br />Planning/Landscape Inspection Required before Final? ❑Yes <br />No <br />"In ieu" Fee: Type: Amount $ <br />Sc ool pa t Fee: tal $ <br />Cal ul ted: Cr dit: <br />[Ell EVerett Sch Dist r7f Mukilteo c of Dist <br />Additional Notes: NQ <br />W+k-ffA,L� rC(!'I/ti+ <br />Approved By:TZ Date: 16 2-7 <br />PUBLIC WORKS' <br />Intake OK by: Date: <br />............................... <br />Intake Comments: PW Worksheet Needed if., <br />©Sys Dev Eval ❑Traffic Mit Eval <br />=0Site Work or Drainage Proposed <br />I]Backflow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />:....................... _........,,.,,.,..,.................,,............. ....,,,.,.,,,..,.,,..................,,.....,.......... <br />...,.........,.....,..., <br />❑ Route this folder for PW Review at end --- PW Review Worksheef <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 Notes: <br />[Approved By: Date: <br />�. j <br />