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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# P-A o f s®O I. <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 <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: El Update Existing ❑New System ❑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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: i PW Worksheet Needed if: <br /> IDSys Dev Eval ❑Traffic Mit Eval <br /> i❑Site Work or Drainage Proposed <br /> Approved By: Date DBackflow Prevention for high hazard: <br /> _(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> - FIRE DEPARTMENT El 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: t:4 This Permit is Approved by Public Works . ;5 <br /> ❑ Se= 'W Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑A Separate - 'ermit is Required(Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this o .- <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Fol.- 'oin with this folder for permit issuance) <br /> Review/Inspection S pe-ADD FIRE FEE ElWill be issued separately(Separate --n Folder,PW issued ahead of Bldg) <br /> Approved By: a"13 Date: �n • 1 5-. ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> E ECTRICAL 'r i t <br /> Additional Notes: A9,1 <br /> Approved By: Date: Approved By: Date: dir71Z0Z,1 <br />