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Intake & Approval Sheet I (FOR PERMIT STAFF ONLY) PERMIT# t►`� \ 1O�'O? E> <br /> BUILDING .�y_ .. . .. <br /> S PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <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 0 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 Uni <br /> Occupancy Load Total No.of Dwelling Units' <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape I -pection 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 0 No ❑Everett Sc •ol Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ Z 3O COO,Oa <br /> Approved By Date: 2_ 1. T.- Z-O 1.0t <br /> ..PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By ",,111- Date: OSAp/? ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> g1 ) 1?>�k''MON`[' ._MA., . El 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---FirePreliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team ❑This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑ Not Req'd ❑A Separate PW Permit is Required(Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: <br /> 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> ❑ ADD FIRE FEE ❑ NO FIRE FEE 0 Public Works has no scope---PW Not Required <br /> Approved By: Date: Additional Notes: <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />