Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF 01VL1 PERMIT # <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 />Garage/Accessory Struct. Size <br />All <br />" ll 0 <br />Number of Stories <br />��- <br />Basement <br />1ANo ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing Chew System El 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? ❑Y^es ❑No <br />LUATION CALCULATION: Total $y <br />15 1 fib I wl� ou <br />Additional Notes: <br />Approved By: ehL Date: 1 O S.3 <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: ❑Update Existing ❑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 />proved 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 />-G <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 MrNo <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total dinxaq <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: ----- <br />Approved By Date: �2 2 <br />PUBLIC WORKS <br />Intake OK by: Date: <br />----------------------------------------- <br />Intake Comments: ; PW Worksheet Needed if., <br />❑Sys Dev Eval ❑Traffic Mit Eva[ <br />OSite Work or Drainage Proposed <br />❑Backflow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />supportive housing) <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 />&This Permit is Approved by Public Works <br />19 See PW Review Worksheet and associated attached items <br />19A Separate PW Permit is Required (Permit #: PWLV-Oq3 ) <br />AND RIs 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 />! <br />Approved By: Date: a$ mil <br />