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• Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT#32o°\---6, <br /> BUILDING PLANNING <br /> Intake OK by: Date: 12 t I a.o 2 Intake OK by: Assign To: Date: <br /> Intake Comment Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <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 Sprinklers: El Update Existing ❑New System Mot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New 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 ❑ No 0 Everett School Dist 0 Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ NCO 00. cc, ' <br /> Approved Byf Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> 'DSys Dev Eval ❑Traffic Mit Eval <br /> I DSite Work or Drainage Proposed <br /> Approved By: 1 Date: gqj I UBackflow Prevention for high hazard: <br /> /""' ;(dental,medical,animals,mortuary,hospital, <br /> { :supportive housing) <br /> FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet <br /> crate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ire Sprinklers Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ht.1,3,r,*f,'-e-✓'k o sfv,R4-4✓• 0 This Permit is Approved by Public Works <br /> a'Zl rfr /NA-, (‘`c, f,,,. c..- ,ji<ike . r-s nct4.4 0 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 /> 0 Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ai Review/Inspection Sco e-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:' -. Date: 2 - 4/- 'z ) El Public Works has no scope--- PW Not Required <br /> ( Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: • Date: <br /> .2/2...._ <br />