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0 • <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# ¶Y' D Cil 6, <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: ✓� Date: /11/1/�q <br /> � <br /> Intake Comments: Intake Comments: Assign To: �I u� i <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone U KYI <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: ,,...��,,// <br /> Fire Sprinklers: ❑Update Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes LVo <br /> Reason Sprinklers Required: "In Lieu")% :Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee. Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No El Everett S of Dist ElMul--aitesZchool Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: L; ize, -(T'( ) i Vt- rty j a-C e/ Iev l-. .(v2 W <br /> VALUATION CALCULATION: Total$ Foa-ld1"OV Up 1-i-S w.)1 ri o-f 1 -e a yl y ►c.t f l e( -than <br /> Approved By" ((* (I Date: I t Df <br /> ll <br /> PUBLIC WORKS <br /> Intake OK by: -IT ts3 Date: Eq iR I t R <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> --,17--aciF;07 Pk c H vx.�1 r. ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ��q�a�c��tJT ❑Site Work or Drainage Proposed <br /> Approved By: Date: (iCt ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet <br /> Separate/De erred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder). <br /> ❑Fire Sprinkle ❑Fire Alarm ❑O • AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑A Separate PW Permit is Required(Permit#: PW ) <br /> ❑ Review of As-B ' Plans-NO E FEE AND ❑ Is located in this folder <br /> ❑ Minimal o o Fire Scope-NO FIRE E 0 Is in a Separate Green Folder Qoin with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE E ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: V�! 'ublic Works has no scope---PW of Required <br /> Additional Not es;:� 87/4 /19 <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />