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0 410 <br /> .� <br /> Intake £Y Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# 0 OI— l 1I . <br /> :UILIIING PLANNING <br /> Intake OK by: Date: • Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> • <br /> ® Route to Commercial Building ® Attach to Project No. <br /> ® Route to Residential Building 0 Route to Historic Reviewer <br /> o Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 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: ®Update Existing ®New System ONot Req'cl School Impact Fee: Total $ <br /> Reason Fire Alarm Required: r Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYeS. ® No ®Everett School Dist ®Mukilteo School Dist - <br /> JAddi RCW 64.55 docs required prior to final? ®Yes ®No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> p chl- 0k . '� 01 , <br /> • ;Approved By: Di <br /> OI ��IC .e <br /> PUBLIC WORKS <br /> Intake OK by: Date: - - <br /> Additional Notes: <br /> Intake Comments: 'PW Worksheet Needed if: <br /> 1❑Sys Dev Eval ❑Traffic Mit Eval <br /> 1 El Site Work or Drainage P :•osed <br /> Approved By: yip Date: =❑Backflow Preventi• for high hazard: <br /> a _(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 ®Fire Alarm ®Other: AND ®Create Green Folder f ubmitted Previously ®Deferred <br /> El This Permit is Approved . Public Works ` <br /> Additional Notes: > pp <br /> 0 See PW Review W.- sheet and associated attached items <br /> Fire Dept. Fees: 1 El A Separate PW "ermit is Required (Permit#: PW ) <br /> ® Review of As-Built Plans-NO FIRE FEE 1 AND 0 Is located in this folder <br /> i 0 Minimal or No Fire Scope-NO FIRE FEE l E Is' a Separate Green Folder Gain with this folder for permit issuance) <br /> ® Review J Inspection Scope-ADD FIRE FEE ! • ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: II Public Works has no scope---PW Not Required <br /> f;'t..itional Notes: <br /> ELECTRICAL - <br /> Additional Notes: <br /> Approved By: Date: iApproved By: Date: <br />