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Intake & Approval Sheet
<br />0 (FOR PERMIT STAFF ONLI9
<br />PERMIT # oq oo2___,
<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 />Bldg/TI/Addn/Rem Size
<br />Garage/Accessory Struct. Size
<br />Number of Stories
<br />Basement
<br />❑No ❑Yes , Fin / Unfin
<br />Type of Construction
<br />Occupancy Group
<br />Occupancy Load
<br />Fire Sprinklers: ❑Update Existing ❑New System
<br />❑Not Req'd
<br />Reason Sprinklers Required:
<br />Fire Alarm: El Update Existing ❑New System
<br />El Not Req'd
<br />Reason Fire Alarm Required:
<br />RCW 64.55 MF worksheet req'd for permit? ❑Yes
<br />❑ No
<br />Add'I RCW 64.55 docs required prior to final? ❑Yes
<br />❑No
<br />VALUATION CALCULATION: Total $
<br />Additional Notes:
<br />Approved By: Date:
<br />FIRE DEPARTMENT
<br />Separate / Deferred Submittals Required:
<br />El Fire Sprinklers El Fire Alarm []Other:
<br />Additional Notes:
<br />Fire Dept. Fees:
<br />❑ Review of As -Built Plans - NO FIRE FEE
<br />❑ Minimal or No Fire Scope - NO FIRE FEE
<br />❑ 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: Date: N oo
<br />Intake Comments:
<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 />r
<br />Proposed No. of Dwelling Units:
<br />Total No. of Dwelling Units:
<br />Planning/Landscape Inspection Required before Final? ❑Yes No
<br />"In eu" Fee: Type: Amount $
<br />School Im-ac�Fee Total $
<br />Calculated: Credit:
<br />❑Everett School Dist ❑Mukilteo School Dist
<br />Additional Notes:
<br />I ( ° 1
<br />Approved By: Date:
<br />PUBLIC WORKS
<br />Intake OK by: Date:
<br />,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
<br />Intake Comments:
<br />PW Workshee t Needed if.•
<br />El Sys Dev Eval []Traffic Mit Eval
<br />❑Site Work or Drainage Proposed
<br />❑Backflow 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 Works heet
<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 loin with this folder for permit issuance)
<br />❑ WIII 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: G` Date:
<br />
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