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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • . PERMIT# -a (q0 t'031 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <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/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> r <br /> Garage/Accessory Struct.Size Zone (—\ <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use \\IQC_V- <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 IZINo <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 El 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: C , Date: V./„.2_03\.0 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: yyV Date: 4,s/iq ❑Backflow 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---FirePreliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team Ur This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing El New System ❑ Not Req'd ❑ A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ❑New System ❑ Not Req'd AND ❑ Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New Sys em ❑ Not Req'd 0 Is in a Separate Green Folder aoin with this folder for permit issuance) <br /> Additional Notes: - FCC..S Kira ElWill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> ItrY*4 <br /> Approved By: )06.Cp WN Date:9-fr--I Ct ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: A eiAvl►IA 1 j�� <br /> ELECTRICAL ' �_(j`F' <br /> Additional Notes: <br /> Approved By: Date: Approved By: ,1- Date: /las) pi, <br />