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Intake & Approval Sheet * (FOR PERMIT STAFF ONLY) • PERMIT # 0 $t(•- 600 <br />BUILDING <br />Intake OK by: Date: // <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Id I/Addn/Rem Size <br />Garage/ ccesso ruct. Size <br />S , <br />Number of Stories <br />I <br />Basement <br />10No ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: El Update Existing ❑New System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes No <br />�7I <br />Add'I RCW 64.55 does required prior to final? ❑Yes KNo <br />VALUATION CALCULATION: Total n <br />Additional Notes: <br />Approved By: Date: 30S <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: ❑Update Existing El New System ❑ Not Req'd <br />Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing ❑New System 1:7 Not Req'd <br />Additional Notes: <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Y Date: �1-?,I-,� <br />Intake Comments: Assign To:-. <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />OK to Route to Other Departments <br />Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />—� <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ZNo <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: Q^t••� - �a <br />J <br />AIDS reAk4A %. ,a� �..�/ -1 3 ram►%- <br />Approved By: <br />Date: <br />PUBLIC WORKS <br />Intake OK by: Date: 4t 12112-61$ <br />----------------------------------------- <br />Intake Comments: ; PW Worksheet Needed if., <br />EW �orfl.�•�.► —.o SV-X: ❑Sys Dev Eval ❑Traffic Mit Eval <br />13 C0 4 --Crr^L. w1EW ; Site Work or Drainage Proposed <br />ttN� bus-6Ac,E ; ❑Backflow Prevention for high hazard: <br />—Arl"P N-10-tLZb --so :(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />ARoute 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 />This Permit is Approved by Public Works <br />❑ 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 (join with this folder for permit issuance) <br />❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved Date: ZC"s his <br />