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• • <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# W90C-0 A <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W" Permit 0 OK to Route to Other Departments <br /> Bidgdk\ddn/Rem Size /OK Zoo SF 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size /11/4 Zone <br /> Number of Stories / Overlay/Agreement <br /> Basement 12dNo Oyes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group s-/1,s Z Q Proposed No.of Dwelling Units: <br /> Occupancy Load 260 Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspecti Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: 4/0 Warr /1E i� "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: otal $ <br /> Reason Fire Alarm Required:4/6) tq Wy - 1t !9 Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes RI No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes �No Additional Notes:� <br /> VALUATION CALCULATION: Total $ Z Oda Ob A �� ' J c)f- ,ems <br /> Approved By:� Date: 0-` \q <br /> PUBLIC WORKS <br /> Intake OK by: t Date: Colt 20 I QI <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> It4p CHov aher- of ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ugt. a — 14 Systf p,c,DSite Work or Drainage Proposed <br /> Date: �� N^"' ❑Backflow Prevention for high hazard: <br /> Approved By <br /> i' � /�` 9 (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet <br /> Separ. /Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sp lers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes. ❑This Permit is Approved by Public Works <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑A Separate PW Permit is Required (Permit#: PW <br /> ❑ Review of As-Built Plans 0 FIRE FEE AND ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scope- • FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-AD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By� I Date: ®6/jJ/Z®,9 ra" 'ublic Works has no scope---PW Not quired <br /> Additional Notes- Cob 8 l 19 <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />