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• 411 +g2,03 -13'� <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S 2-1 03 - 00(o <br /> BUILDING . . <br /> PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: _ <br /> Intake Comments: Intake Comments: <br /> ; ,�coy ©sY '�` <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone MU <br /> Number of Stories l ter "C trAd e.Cs'" <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use c'e\,A' <br /> Type of Construction Residential Use ^-- <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: r—• ` <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Nat 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 El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Cred' : <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Muki -o School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ /F-perr, <br /> Approved Byi.-"-----'c_ Date: "S, \R, t, <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: 1PW Worksheet Needed if: <br /> 76 ,/l IOSys Dev Eval L7Traffic Mit Eval <br /> � /� / DSite Work or Drainage Proposed <br /> Approved By: Date: 3/ .2- 'OBackflow Prevention for high hazard: <br /> 1 J (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: OThis 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: 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 ❑ 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 /> \y Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 2.--/z_ <br />