Laserfiche WebLink
Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) i PERMIT# 62C�( a 083 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: _ Date: <br /> Intake Comments: Intake Comments: <br /> %)n tyv) <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 /> Bidg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone gial <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use MJI��- nn1� <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? ClYesOlo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount <br /> Fire Alarm: ❑Update Existing ❑New System ONot 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 S ool Dist <br /> Add'l RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> t I'D;'IOU <br /> vie �� <br /> 4&L S !V N•1 v"'g. Approved By: / Date: ta---"Z,-1.� -Z-eD <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: 'PW Worksheet Needed if: <br /> ,Sly �r� .., `b�y.��,�, oSys Dev: 1Dra ; ::a1 <br /> my USite Wor <br /> Approved By: Date: I a II 3 rf_o I I]Backflow Prevention for high hazard: <br /> :(dental,medical,animals,mortuary,hospital, <br /> 1y41 R�,p isupportive housing) <br /> FIRE DEPARTMENT' DRoute 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted Previously ❑Deferred <br /> Additional Notes: CIThis 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 /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑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: �� Date: %Q 1 Ii( <br />