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�6001���' <br />I" <br />Intake & Approval (FOR I' <br />0 . PERMIT #611 I D- D 15 <br />BUILDING <br />Intake OK by: Date: <br />ake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />Z <br />Garage/Accessory.Struct. Size <br />Number of Stories <br />2- <br />Basement <br />14No ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />W <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System El 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? ❑rrYes ❑No <br />LUATION CALCULATION: Total <br />no\' W bE& <br />Additional Notes: <br />Approved By: Date: I %Z3� <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: (OK to Route to Other Departments) <br />Fire Sprinklers: El Update Existing El New System ❑ Not Req'd <br />Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing ❑New System ❑ Not Req'd <br />Additional Notes: <br />46proved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Date: <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 />EDO <br />Nonresidential Use <br />---"-' <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes RINo <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: ?j <br />PUBLIC WORKS <br />Intake OK by: Date: <br />----------------------------------------- <br />Intake Comments: Comments: ;PWWorksheet Needed if. • <br />❑Sys Dev Eval ❑Traffic Mit Eva] <br />❑Site Work or Drainage Proposed <br />OBackflow 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 Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />1WThis Permit is Approved by Public Works <br />91 See PW Review Worksheet and associated attached items <br />ErA Separate PW Permit is Required (Permit#: PWI911--0g7 ) <br />AND EL 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 />O�q <br />