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0 <br />Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT <br />BUILDING <br />Intake OK by: Date: 611311,v <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 />�j S <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />LKNo ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />VZq <br />Occupancy Load <br />Fire Sprinklers: El Update Existing El New System El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: El Update Existing El New System El Not Req'd <br />Reason Fire Alarm Required: <br />r� <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes El No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes Eallo <br />VALUATION CALCULATION: Total $ 113 -7'7¢ <br />24g el2l OjLSSB <br />4oI- e4$ lG,icilo <br />z-j' e 30 Z Z0 <br />,{8 &2-5' 11,Oc;, <br />Additional Notes: 1ec- (�fS'LCC <br />Approved By: Date: -7 / Z <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />9Minimal or No Fire Scope - NO FIRE FEE <br />❑ Review / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: — <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Date: <br />Intake Comments: Assign To: Ox O\� <br />Au� � <br />❑ Attach to Project No. <br />❑l, Route to Historic Reviewer <br />L� 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 />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes IK]No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total <br />Calculated: Credit: <br />❑Everett School st ❑Mukilteo School Dist <br />Additional Notes: <br />Approved By: Date: \ �� <br />PUBLIC WORKS <br />Intake OK by: Date: CC , :J <br />----- --- - - as---- <br />Intake Comments: PW Worksheet Needed if. <br />VS-'.a.% <br />Sys Dev Eva] ❑Traffic Mit Eval <br />p� p p jti eaEy,� :Site Work or Drainage Proposed <br />: ❑Backflow Prevention for high hazard: <br />S��tf�L :(dental, medical, animals, mortuary, hospital, <br />/tom EQ <br />:supportive housing) <br />:----------------------------------------- <br />goute 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 />is Permit is Approved by Public Works <br />U&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 coin 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: ��.� �� , �,•-,r,, A�� a ;v <br />Approved By: Date: <br />