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intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# ,M Z (O' —05 zj <br /> BUILDING PLANNING . • <br /> Intake OK by: Date: Intake OK by:04 Assign To: IW)3, Date:7-20' 2-4 <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Re to 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 L a... <br /> Number of Stories Overlay/Agreement _ <br /> Basement ❑No ❑Yes, Fin 1 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 ONot 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 ONew 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 0 No DEverett School Dist ❑Mukilteo❑ School Dist <br /> ",,„� <br /> Add'I RCW 64.55 does required prior to final? Yes 0 No Additional Notes: Li fie,-� (i r^.�Ja..c:Ii. <br /> VALUATION CALCULATION: Total$ / 9 <br /> Approved By:A6 Date: 7. 20.2421 <br /> PUBLIC WORKS.' <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> 3DSys Dev Eval ❑Traffic Mit Eval <br /> CI Site Work or Drainage Proposed <br /> Approved By: Date: 0-7 yterzi ;❑Backflow Prevention far 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 /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND El 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 ❑ 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 /> Zf <br />