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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# Mant 2-o <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> D Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> 121 Make this a"W" Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone I --S <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 ONew System Mot Req'd Planning/Landscape Inspection Re. i fired before Final? DYes EZI_No <br /> Reason Sprinklers Required:Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: DUpdate Existing ONew 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? DYes ❑No ❑Everett School Dis OMukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total $ <br /> Approved By: ' Date: \2 `1�,/i.,C)/j3 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: i PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ;Mite Work or Drainage Proposed <br /> Approved By: (.)VDate: yV__(//1.4,2,i I I�Backflow Prevention for high hazard: <br /> =(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE.DEPARTMENT ❑Route this folder for PW Review at end --- PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) This project also has a separate concurrent PW Review (Green Folder) <br /> ❑Route to Fire Drawer--- Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ODeferred <br /> DSending Fire Notes to Project Team ❑This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ONew System ❑ Not Req'd ❑A Separate PW Permit is Required(Permit#: PW ) <br /> Fire Alarm: 0Update Existing ❑New System D Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ELpdate Existing ❑New System D Not Req'd ❑ Is in a Separate Green Folder (join with this folder for permit issuance) <br /> Additional Notes: D 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: <br />