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w) i i 0r <br />Intake & Approval Sheet (FOR PERMIT STAFF ONLr <br />PERMIT # V 1611 D- 00� <br />4 <br />BUILDING <br />Intake OK by: Date: <br />,ake Comments: <br />i <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 />2- <br />Basement <br />154No ❑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: El Update Existing El 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 dots required prior to final? ❑Yves ❑No <br />VALUATION CALCULATION: Total $y <br />2oi5 1 YLG I NA) ICJ <br />Additional Notes: <br />Approved By: Date: o ' <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 El New System ❑ Not Req'd <br />Chemical Sup: El Update Existing El New System ❑ Not Req'd <br />Additional Notes: <br />"nproved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />7Ap proved 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 />r <br />L <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 RINo <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ >f! <br />Calculated: Credit:_ <br />❑Everett School Dist ❑Mukilteo School Dist <br />Additional Notes:---�'� <br />Approved By: Date: <br />1011 <br />PUBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: ;PW Worksheet Needed if., <br />❑Sys Dev Eva] ❑Traffic Mit Eval <br />❑Site Work or Drainage Proposed <br />❑Backf]ow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />;supportive housing) <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 />aSee PW Review Worksheet and associated attached items <br />A Separate PW Permit is Required (Permit #: PW <br />AND 19�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: ate: `O u '&T 9 <br />