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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#�2C)C2— 0 <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 6 <br /> Number of Stories Overlay/Agreement <br /> Basement El No • es , Fin/Unfin Nonresidential Use ��,^P7 1\ <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 Exi ng ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes tgi4kNo <br /> Reason Sprinklers Requir- "In Lieu"Fee:Type: Am nt$ <br /> Fire Alarm: ❑Upd. Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm -quired: Calculated: Cred' . <br /> RCW 64.55 MF wo sheet req'd for permit? ❑Yes ❑ NO El Everett School Dist ❑Mukilte School Dist - - <br /> Add'I RCW .55 docs required prior to final? ❑Yes ❑No Additional Notes: L.2:,3w,s- <br /> VALU ION CALCULATION: Total$ „J C V [1,�,�, �, r <br /> tJ�- - � ✓:a,,.tx-'r �-e, IoCz-lz� vl��� ��Sri� e,462-ci <br /> Approved By: 'M4 Date: I a- Z2_ac <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: �'c Date: �//y hl ;OBackflow Prevention for high hazard: <br /> / ;(dental,medical,animals,mortuary,hospital, <br /> _supportive 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 /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> 0 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 /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> O Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: A Date: <br />