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Intake &Approval Sheet S (FOR PERMIT STAFF ONLY) • PERMIT# 22-01—DD I <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> • <br /> Intake Comments: Intake Comments: <br /> • <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑Route to Residential Building 0 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 /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <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 ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El 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 ❑Everett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: =PWWorksheet Needed if: <br /> = Sys Dev Eval OTraffic Mit Eval <br /> LISite Work or Drainage Proposed <br /> Approved By: Date: iDBackflow Prevention for high hazard: <br /> • ;(dental,medical,animals,mortuary,hospital, <br /> !supportive housing) <br /> • <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: A D ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: his 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 0 Is in a Separate Green Folder(join with this folder for permit Issuance) <br /> T`Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:\K,1 IAN Date: )_J j— ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: U,,�,vf >pebA p�- _ <br /> ELECTRICAL 0�`1�VU I1 '►'M �klaa. � UA.Ci t?'Z(ld�i� �'v�r►o4'titirtT vC+ti <br /> Additional Notes: gaff 4 (C-GI,' <br /> Approved By: Date: Approved a 1: " ' ' Date: I( (2,92.71.. b„�j <br />