Laserfiche WebLink
• i Q <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �]2 (c XOS <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" mit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn(gem Size) o�Gt? < ' ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size --- Zone u f2 +I <br /> Number of Stories / Overlay/Agreement <br /> Basement WNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction V /-S Residential Use <br /> Occupancy Group ri. Proposed No.of Dwelling Units: <br /> Occupancy Load HI A- Total No.of Dwelling Units: <br /> Fire Sprinklers: El Update Existing El New SystemNot Req'd Planning/Landscape Inspection Required before Final? I 'eslo <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System 14Not 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 Sc.•01 Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes No Additional Notes: <br /> VALUATION CALCULATION: Total $ (9q/4�� �� �� 1 no '� <br /> Approved By: �, Date: 7.12,.2,/ <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =PWWorksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: L, js Date:oL l/f/ ❑Backflow Prevention for high hazard: <br /> / ;(denlidical,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(join 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: [,ti..� Date: /1J/ / Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Z_. Date: vZ C7C N47 <br />