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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) 0, PERMIT# YV20O33-033 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> CO%1 Pak+' C.T 'Cep *5-64 69CO <br /> ❑ Route to Commercial Building 0 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 YTI Addn/Rem Size SS? ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size /f ;Q Zone Ivk <br /> Number of Stories I Overlay/Agreement <br /> Basement No ❑Yes , Fin/Unfin Nonresidential Use res\-ovktoaA <br /> Type of Construction Va Residential Use <br /> Occupancy Group /5 Proposed No.of Dwelling Units: <br /> Occupancy Load /S Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System EINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: , :• $ <br /> Fire Alarm: gtJpdate Existing ❑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 1,2 No El Everett School D'- ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Note <br /> VALUATION CALCULATION: Total$ go 000.00 <br /> i <br /> Cokea (�v , . 17n Approved B Date: 6.\Qr..Z,C)Z(`) <br /> 1 PUBLIC WORKS <br /> As ov tC CA G� w o ia? <br /> �i y <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =PW Worksheet Needed if: <br /> DSys Dev Eval ❑Traffic Mit Eval <br /> DSite Work or Drainage Proposed <br /> Approved By.: Date: dy Q6��ve =�Backflow Prevention for high hazard: <br /> i(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE DEPARTMENT iv El Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required:1` ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers IFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: , ❑ This Permit is Approved by Public Works <br /> 1 y Pet \ohX ❑ See PW Review Worksheet and associated attached items AIIP" <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 Qoin with this folder for permit issuance) <br /> ® Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:'SLyCp toN Date: 3-,22-1 2b1/ TiPublic Works has no scope---PW Not Required <br /> Additional Notes: A.a. k4 ' work__ I <br /> ELECTRICAL �' <br /> Additional Notes: <br /> Approved By: Date: Approved By: JAI* Date: 447,0 2.0 <br />