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Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLY) 0 PERMIT4`9 2z 11- 02, <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />11 Route to Commercial Building <br />El Route to Residential Building <br />El Make this a "W" Permit <br />Bldgf-FI/Addn/Rem Size <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />[]No 0Yes Fin Unfin <br />Type of Construction <br />Occupancy Group <br />0 <br />Occupancy Load <br />Fire Sprinklers: DUpdate Existing ONew System -ONot Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: El Update Existing ONew System 13Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? 0Yes In No <br />Add'l RCW 64.55 docs required prior to final? ElYes EINo <br />VALUATION CALCULATION: Total $ 7, <br />T .1 _x <br />Additional Notes: <br />lApproved By: Z___2�r Date, <br />k�/)3 /C�Z/__J <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ElFireAlarm DOther: <br />Additional Notes: <br />Fire Dept. Fees: <br />El Review of As -Built Plans - NO FIRE FEE <br />El Minimal or No Fire Scope - NO FIRE FEE <br />El Review / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: 4al—C, Date: <br />Intake Comments: <br />�14c con n(14- vt-(NiAxd <br />� Attach to Project No. n ct <br />El Route to Historic Reviewer <br />El OK to Route to Other Departments <br />11 Hold in Planning File Drawer <br />Zone <br />Over] ay/Ag reem ent <br />Nonresidential Use <br />Residential Use <br />SELL <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ElYes RNo <br />"In Lieu" Fee: Type: --_-Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />[]Mukiltea School Dist <br />El Everett School Di:!L <br />Additional Notey/ <br />Date: \T,QA, � 0120 <br />PUBLIC WORKS <br />Intake OK by: Date: <br />............................ 11 ...................... .............................. .......... ........... <br />Intake Comments: <br />WorksheetNeeded if. <br />Sys D ev Eva I ElTraffic Mit Eval <br />PSite Work or Drainage Proposed <br />2013ackflow Prevention for high hazard: <br />,(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />........ . ..................... I ...... . ..... ........... .......... .......... <br />DRoute this folder for PW Review at end --- PW Review Worksheet <br />OThis project also has a separate concurrent PW Review (Green Folder) <br />AND ElCreate Green Folder []Submitted Previously ElDeferred <br />2 <br />EJ This Permit is Approved by Public Works <br />aSee PW Review Workshe . et and associated attached items <br />IRA Separate PW Permit is Required (Permit #: PW <br />AND I%s located in this folder <br />1:1 Is in a Separate Green Folder Coin with this folderforpermit issuance) <br />El Will be issued separately (separate Green Folder, PW issued ahead of Bldg) <br />El Public Works has no scope --- PW Not Required <br />Additional Notes: <br />ved By: Date: -10 <br />