Laserfiche WebLink
Intake & Approval Sheet *(FOR PERMIT STAFF ONLY) PERMIT # <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bld I/ do/Rem Size <br />Ga ge/Accessory Struct. Size <br />Number of Stories <br />Basement <br />1,31N o OYes, Fin / Unfin <br />Type of Construction <br />-� ) <br />Occupancy Group <br />Occupancy Load <br />Q <br />Fire Sprinklers: pdate Existing El New System El Not Req'd <br />Reason Sprinklers Required: jL1QLMWe- <br />Fire Alarm: Update Existing El New System El Not Req'd <br />Reason Fire Alarm Required: JAL'" <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes No <br />Add'] RCW 64.55 docs required prior to final? ❑Yes fONo <br />VALUATION CALCULATION: Total $ <br />Additional Notes: C P*4 Aalr .114 <br />cc <br />Approved By: Date: ;a cj <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑ Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: apdate Existing ❑New System <br />❑ Not Req'd <br />Fire Alarm: Mpdate Existing El New System <br />❑ Not Req'd <br />Chemical Sup: ❑Update Existing ❑New System <br />❑ Not Req'd <br />Additional Notes: <br />Approved By 3cs Date: 10 <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake 0KdS Date: Z <br />Intake Comments: Assi n T <br />U° (.04 J' 'n P 10 <br />yj�b� <br />tyvid,sa&7 <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />0 OK to Route to Other Departments <br />old in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use�o�y� <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes WNO <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Creel" <br />❑Everett School Dist E]Mjikeeo School Dist <br />Additional Notes: <br />Approved By: Date:®✓ Zs� 1 <br />\- <br />PUBLIC WORKS <br />Intake OK by: bate: 0 20 <br />---- --- --------------- --------- <br />Intake Comments: ; PW Worksheet Needed if: <br />;Sys Dev Eval ,Traffic Mit Eval <br />❑Site Work or Drainage Proposed <br />❑Backflow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <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 />This Permit is Approved by Public Works I <br />❑ See PW Review Worksheet and associated attached items N <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 folder for permit issuance) <br />❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: SYs EV N 81605-01� iar /00°0 <br />7&MC �rr�l. paid w/816os-or�-�gr lq��, Ws�liet • <br />a N 6W �s dal: <br />Approved By: . Date: D <br />