Laserfiche WebLink
411° <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# a 2 DD$ -ix Z <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/AdSize '70 irr ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Z2,,sF Zone 't--Z-- <br /> Number of Stories Z • Overlay/Agreement <br /> Basement ►-No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction u8 Residential Use l <br /> Occupancy Group ye—,3 Proposed No.of Dwelling Units: <br /> Occupancy Load , (7 Total No.of Dwelling Units: I <br /> Fire Sprinklers: ❑Update Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes to <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Am <br /> Fire Alarm: El Update Existing El New System ®Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: C dit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes p.No ❑Everett School Dist ❑Muki eo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: 1r 1,. ' d`1 - •fe(vw OWN <br /> S <br /> VALUATION CALCULATION: Total$ '0U 00 U(�'� 'IV- 2 t\J `)& M 1 1%o '77 <br /> Approved By: tc_. Date: $may 7 <br /> BLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> 'DSys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By ,�o Date: �d 2 ,a'Z t� =0Backflow Prevention for high hazard: <br /> �.. !!• ;(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: 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-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(loin with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope---PW Not Required <br /> Additional Notes: a ,,V� , tD , _ ,I <br /> ELECTRICAL ,�V v1�tT• � <br /> Additional Notes: <br /> Approved By: Date: Approved By: _} - Date: to 1- /no <br />