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Intake &Approval Sheet • (FOR PERMIT STAFF OILY)• PERMIT#K21)02..-°O <br /> BUILDING PLANNING <br /> _ <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> VIDts 0 , <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 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 .nits: <br /> Occupancy Load Total No.of Dwelling U s: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscap Inspection Required before Final? ❑Yes El No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type• Amount$ <br /> Fire Alarm: ❑Update Existing ONew System ❑Not Req'd School Impact F•e: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett hool Dist ❑Mukilteo School Dist <br /> Add'l RCW 64.55 docs required prior to final? ❑Yes ❑No Additional otes: <br /> VALUATION CALCULATION: Total$ 4 o,L100 <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =PW Worksheet Needed if: <br /> DSys Dev Eval ❑Traffic Mit Eva! <br /> I OSite Work or Drainage Proposed <br /> Approved By: Date / ip_49.49 ❑Backflow Prevention for high hazard: <br /> / (dental,medical,animals,mortuary,hospital, <br /> 'supportive housing) <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 /> ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: TZ is 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 /> r8 Review/Inspection Sco e-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: �j- Date: /.125 ZV ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> E ECTRICAL MA- R�e�' CC) `2-`Z 1 I�4-c) <br /> Additional Notes: <br /> Approved By: Date: Approved Date: dZ 27 Zeac, <br />