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-�-- <br />Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLY PERMIT # 31b 6 " ✓J <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make t ' " Permit <br />Bldg/TI/A /Rem Si <br />J-76 6�e <br />Garage/Accessory Struct..Size <br />A11-4 <br />Number of Stories <br />Basement <br />❑No 29Yes, Fin / Unfin <br />Type of Construction <br />B <br />Occupancy Group <br />2-- 3, <br />Occupancy Load <br />J <br />Fire Sprinklers: ❑Update Existing ❑New System NNot Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes Jfl No <br />Add'I RCW 64.55 docs required prior to final? []Yes No <br />VALUATION CALCULATION: Total $ 57 60d''• ©0 <br />r76 X jpo Z 695b <br />Additional Notes: <br />Approved By Date:O %Z/ <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />❑ Minimal or No Fire Scope - NO FIRE FEE <br />Review/ Inspection Scope - ADD FIRE FEE <br />Approved By: K, OCDate: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: Date: <br />Intake Comments: <br />Flo sc�noo\ �ac� �eQ c, <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />( <br />Planning/Landscape Inspection Required before Final? Yes ISNo <br />"In Lieu" Fee: Type: Amo <br />School Impact Fee: Total $_ <br />Calculated: Credit: <br />�Er]Mukilteo <br />J lEverett School Dis School Dist <br />Additional Note <br />Approved By: Date: , t <br />PUBLIC WORKS <br />Intake OK by: Date: <br />_.__w..... _............. .,,,,,...... ................. ............ ; _.._._............ ....... <br />Intake Comments: PW Worksheet Needed if., <br />l]Sys Dev Eval ❑Traffic Mit Eval <br />[]Site Work or Drainage Proposed <br />❑Backf ow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />,supportive housing) <br />e..................,......,............,..,.._...._.. W........................._.._....___.... ......... <br />❑ Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />IkThis Permit is Approved by Public Works <br />See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folderfor permit issuance) <br />❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: Date: pZ 1 4k -jam ( <br />