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• • <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 2 LO " I Z . <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> -- Garage/Accessory Struct.-Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> . Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes. ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> fifi d i " ok rei ,� <br /> • Approved By: Dite: b <br /> I � I z,e) <br /> PUBLIC WORKS <br /> Intake OK by: Date: - <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> =DSys Dev Eval ❑Traffic Mit Eval <br /> =DSite Work or Drainage P :.osed <br /> Approved By: rA% Date: ❑Backflow Preventi. for high hazard: <br /> (dental,medical,a • als,mortuary,hospital, <br /> :supportive hou ' g) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end -PW Review Worksheet <br /> Separate/Deferred Submittals Required:. ❑This project also has a separate co- urrent PW Review(Green Folder) <br /> ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ■ " ubmitted Previously ❑Deferred <br /> Additional Notes: ; ❑ This Permit is Approved . Public Works <br /> ❑ See PW Review W. sheet and associated attached items <br /> Fire Dept.Fees: ❑ A Separate PW "ermit is Required (Permit#: PW <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is to :ted in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is• a Separate Green Folder coin with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE I ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope---PW Not Required <br /> itional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />