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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# . -0 / ,--08 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Rezoied vb B Qrair , /5-13,f‘_, 6 0,A-03en A- <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 �(���� <br /> 0 OK to Route to Other Departments 6eitt''0 <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer 12Njw ..v► +1 <br /> Garage/Accessory Struct.Size Zone B <br /> Number of Stories Overlay/Agreement - _ <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . \W '� '' <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 Rio <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: A unt$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Cr it: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Muki eo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑YYes ❑No Additional Notes:r <br /> VALUATION CALCULATION: Total$ 3, Oo <br /> Approved By: V.., t Date: 1 .$,2,1 <br /> UBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: 1kvW0Tks he et Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> j El Site Work or Drainage Proposed <br /> }��, ?❑Backflow Prevention for high hazard: <br /> Approved Date:f3'l (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 /> El Fire Sprinklers El 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 0 Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: ! 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: l{rk Date: 1 <br /> / kZ,f y,' <br />