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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# MI-1®"I — ' <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK byg Assign To:ik,156.6). Date:Cy 1412624 <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building / ❑ Attach to Project No. <br /> ❑ Route to Residential Building ' El Route to Historic Reviewer <br /> El Make this a"W"Permit % 123‘OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone 1 "U <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Ye , Fin/Unfin Nonresidential Use (gfOLer1StA'c <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: DUpdate .'fisting ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Re.aired: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑.pdate Existing ❑New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Al. m Required: Calculated: Credit: <br /> RCW 64.5' i worksheet req'd for permit? ❑Yes ❑ No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes No Additional Notes: <br /> VALUATION CALCULATION: Total$ �0\ <br /> Approved By: ag, Date: (V <br /> PUBLIC WORKS <br /> Are <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: jPW Worksheet Needed if: <br /> SOSys Dev Eval ❑TrafficMit Eval <br /> I DSite Work or Drainage Proposed <br /> Approved By: Date:b/e <br /> j OBackflow Prevention for high hazard: <br /> =(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> L. <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 El Fire Alarm DOther: AND ❑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 />