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�m)� 01161D- ©0z <br />Inn afte & Approval Sheep W (FOR PERMIT STAFF ONL,0 <br />PERMIT #�`qpb, 0l9 <br />BUILDING <br />Intake OK by: Date: <br />ake Comments: <br />Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />Z <br />(Garage/Accessory,Struct. Size <br />?j <br />Number of Stories <br />2 <br />Basement <br />No ®Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Lk <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑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 />Add'I RCW 64.55 docs required prior to final? 0 <br />7Y�es r-❑No <br />VALUATION CALCULATION: Total $ �J ! �� lo�• �C <br />Joe <br />Additional Notes: <br />[Approved By: --- Date: ,sZ ` <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />FA 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 ❑New System ❑ Not Req'd <br />Fire Alarm: El Update Existing ❑New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing El New System ❑ Not Req'd <br />Additional Notes: <br />oproved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />Intake OK by: <br />Intake Comments: <br />PLANNING <br />Date: <br />Assign To: <br />E Attach to Project No. "oU (b1 q -D D� <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />® Hold in Planning File Drawer <br />Zone I \N - (/ <br />Overlay/Agreement I <br />Nonresidential Use -�- <br />Residential Use <br />Proposed No. of Dwelling Units: i <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes Mo <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ (VtOA4G�( <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist <br />!Additional Notes: <br />lAnDroved Bvl A--47-%A1 Date: (-A' 1 1 1 C1 II <br />PUBLIC WORKS <br />Intake OK by: Date: <br />----------------------------------------- <br />Intake Comments: ;PWWorksheet Needed if.• <br />El Sys Dev Eval ❑Traffic Mit Eva[ <br />: ❑Site Work or Drainage Proposed <br />' OBackflow Prevention for high hazard: <br />:(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />'----------------------------------------- <br />❑Route 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 />2 This Permit is Approved by Public Works <br />tR See PW Review Worksheet and associated attached items <br />O'A Separate PW Permit is Required (Permit #: PW 19097058 ) <br />AND 91s 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 By: Date: <br />4 <br />