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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 1-- 2. \ d 3" D(4'14 <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 /57 ! ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone ig---2_ <br /> Number of Stories VS <br /> / Overlay/Agreement <br /> Basement ILPNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction �Residential Use l <br /> Occupancy Group c..4 Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: 11 <br /> Fire Sprinklers: ❑Update Existing ❑ _New System iNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes Olo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ / <br /> Fire Alarm: El Update Existing El New System Mot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Ytis I No El Everett School Dist ❑Mukilteo ool Dist <br /> Add'I RCW 64.55 docs required prior to final? //❑Yes in No Additional Notes: <br /> VALUATION CALCULATION: Total$ Ge1 /f) <br /> 0 Approved By: Date: 3 (/0 i\ <br /> 11)V x 'Z' oo ,41 1g1I h J <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: DPW Worksheet Needed if: <br /> ❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date:el/�/�� ❑Backflow Prevention for high hazard: <br /> I(dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers El 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 /> ❑ 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: 1/29/20 Zt <br />