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Intake & Approval Sheep` (FOR PERMIT STAFF ONLY) PERMI r # <br />BUILDING <br />Intake OK by: Date:_ _ <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />Garage/ ccessory truct. Size <br />Sr <br />Sr <br />Number of Stories <br />Basement <br />91No ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: []Update Existing ❑New System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System El Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No <br />VALUATION CALCULATION: Total $ Z S g� <br />Additional Notes: ZOI 5 /9 C. <br />Approved By: Date: �a / <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additiona Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - FIRE <br />El Minimal or No Fire Sco - NO FIRE FEE <br />ElReview/ Inspectio cope - ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Dater <br />T <br />Intake Comments: Assign To: ' <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />Hold in Planning File Drawer <br />Zone <br />— <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />t <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? <br />❑Yes ❑No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />El Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: <br />Approved By: <br />Date: 5 <br />PUBLIC WORKS <br />Intake OK by: Date: 5 <br />---------------------------- <br />Intake Comments: ;PWWorksh etNeededif.• <br />❑Sys Dev Eval ❑Traffic Mit Eval <br />gX1 Z "qlo g�L F7— ; ❑Site Work or Drainage Proposed <br />❑Backflow Prevention for high hazard: <br />;(dental, medical, animals, mortuary, hospital, <br />;supportive housing) <br />'----------------------------------------- <br />Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />This Permit is Approved by Public Works <br />See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) <br />❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved B Date: e� jp <br />