Laserfiche WebLink
Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# 0 ' UW.C/ <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK b Assign To: ()ea)IS Date: 2/d% <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No.IKERQ Y-V <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 SprinklersT 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: Update Existing El 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 ❑ 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$ ‘©D <br /> Approved Bar U, \) �('�/ � Date: ZV2)312g2( <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if.: <br /> � dee) "I_Sys Dev Eval ❑Traffic Mit Eval <br /> �� IDSite Work or Drainage Proposed <br /> Approved By: Date: c l(y z.i OBackflow Prevention for high hazard: <br /> d :(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: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ErFire Sprinklers Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: Ig,This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items N fA <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: K brof.)h Date:p2-;23 al./ ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: /pi os f d A R ezra ovv. <br /> ELECTRICAL , R /'�` IP r 4 <br /> Additional Notes: �) �, c&c rnit k <br /> Approved By: Date: Approved By: Dat iga100 <br /> 24- <br />