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<br />Intake & Approval Sheet (FOR PERMIT STAFF ONLY?
<br />• PERMIT # @-2V0 Q' C�
<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 />j Coo
<br />Garage/Accessory Struct. Size
<br />-
<br />Number of Stories
<br />Basement
<br />❑No ❑Yes , Fin / Unfin
<br />Type of Construction
<br />V- Pl
<br />Occupancy Group
<br />Occupancy Load
<br />Fire Sprinklers: ❑Update Existing ❑New System RNot 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 PpNo
<br />VALUATION CALCULATION: Total $ i `t 3 Lori
<br />1 to tv r 12l
<br />Additional Notes:
<br />Approved By: Date: 1 p ,fi n
<br />FIRE DEPARTMENT
<br />Separate / Deferred Submittals Required:
<br />❑Fire Sprinklers ❑Fire Alarm El 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 />❑ 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: ',4NW Assign To: Y- Date:
<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 />-
<br />Overlay/Agreement
<br />Nonresidential Use
<br />Residential Use
<br />Proposed No. of Dwelling Units:
<br />--
<br />Total No. of Dwelling Units:
<br />�-
<br />Planning/Landscape Inspection Required before Final? ❑Yes No
<br />"In Lieu" Fee: Type: Am<biunt $
<br />School Impact Fee: Total $
<br />Calculated: Credit:
<br />El Everett School Dist ukilteo School Dist
<br />Additional Notes:
<br />Approved By: j }
<br />Date: �EZ-I-Zpa
<br />PUBLIC WORKS
<br />Intake OK by: Date:
<br />,....,.
<br />PW Workshe
<br />Intake Comments: - et Needed if:
<br />❑Sys Dev Eva ❑Traffic Mit Eval
<br />❑Site Work or Drainage Proposed
<br />❑Backflow Prevention for high hazard:
<br />:(dental, medical, animals, mortuary, hospital,
<br />:supportive housing)
<br />.......... ..... ..... ...... ... 1.,,,,.,.,,.,,.,.......,.,..,,,..,,,,,.,,,,.,,,,,.,,,,...,..........,,.,,,,.,,,,,.,,,,.,,,,,.,....,,,,.,,,,,
<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 />N 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 coin 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; K Date: to �,0
<br />
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