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Intake $ Approval Sheet 0 (FOR PERMIT STAFF ONLr • . PERMIT <br />51wtP-a03 <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 />BldgM/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 El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing El New System El 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? ❑Yes ❑ No <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />Approved By: Date: jlj <br />u <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 ❑New System ❑ Not Req'd <br />Fire Alarm: ❑Update Existing El New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing ❑New System ❑ 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: Date: <br />Intake Comments: Assign To: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />OK to Route to Other Departments Y,e 17- I cl. I <br />Hold in Planning File Drawer <br />Zone <br />s <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />r�Q� <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes UNo <br />"In Lieu" Fee: Type: Amoun <br />School Impact Fee: Total $ <br />Calculated: redit: <br />❑Everett School Dist ukilteo School Dist <br />Additional Notes: 'Lo-tom <br />a <br />Approved By: Date: <br />PUBLIC WORKS <br />Intake OK by: Q " Date: 12- <br />Intake Comments: ;PWWorksheet Needed if.• <br />❑Sys Dev Eva] ❑Traffic Mit Eva] <br />❑Site Work or Drainage Proposed <br />I -Au 'Sys -re&. -06v 1::" 5 <br />❑Backflow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <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 />This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />A Separate PW Permit is Required (Permit #: PWAI <br />AND AIs 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:' 7 <br />