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9 <br /> Intake &Approval Sheet II (FOR PERMIT STAFF ONLY)• PERMIT# -1 -- Oil <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 /> Bld I/ ddn/Rem Size Z3 7fZ ,cS''ir 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size e✓,,>s Zone 11-1L <br /> Number of Stories / Overlay/Agreement <br /> Basement EINo ❑Yes , Fin/Unfin Nonresidential Use e r ct013e/4od Qo,ads elan <br /> Type of Construction 21.-8 Residential Use <br /> Occupancy Group F/ Proposed No.of Dwelling Units: <br /> Occupancy Load / Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing NNew System El Not Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existingn 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? oyes is No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes 13No Additional Notes: g,�l s „ ` _r„ <br /> VALUATION CALCULATION: Total$ oco.00 'v roAir 604Q-i <br /> r"_ <br /> Approved By: V, Date: A-4,2,07_0 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> t <br /> OSys Dev Eval OTraffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> Approved B ' Date: 29"Liro .o 1 OBackflow Prevention for high hazard: <br /> !(dental,medical,animals,mortuary,hospital, <br /> Isupportive housing) <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 concurrent PW Review(Green Folder) <br /> tie-Fp <br /> ire Sprinklers Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑ A Separate PW Permit is Required(Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> 0 Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> EI-Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separat eparate Green Fo , W issued ahead of Bldg) <br /> Approved By: G,Bnow Date:S-62420 Public Works has no scope-- t Required <br /> d itional Notes: <br /> ELECTRICAL bit, <br /> i <br /> /,� I ' ��n (�Additional Notes: r� ,;/J%/( UI' 1 P <br /> Approved By: Date: Approved By:saily'iiii Date: <br /> ettjrin i WeAhri/ - <br />