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• • Q <br /> Intake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# (SO 1 -t e <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 0 Route to Historic Reviewer <br /> ❑Make this a"W' Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <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 ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee: 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 ❑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$ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PWWor*sheet Needed if: <br /> ©Sys Dev Eval ❑Traffic Mit Eval <br /> ©Site Work or Drainage Proposed <br /> Approved By: Date: =DBackflow 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 /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review (Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary Review Notice AND OCreate Green Folder ❑Submitted Previously ❑Deferred <br /> Mending Fire Notes to Project Team 0 This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd ❑A Separate PW Permit is Required (Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System El Not Req'd 0 Is in a Separate Green Folder (join with this folder for permit issuance) <br /> Additional Notes: ❑ 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: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved B Date: l6%l// Approved By: Date: <br /> ,2z <br />