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Intake & Approval Sheet 0 (FOR PERMIT STAFF ONL'i s # '`�1�" 025 BUILDING PLANNING Intake OK by. ' Date: f2/l9/�/� Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit ® OK to Route to Other Departments Bldg/TI/Addn/Rem Size 4E5 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size — Zone 9.-2. Number of Stories 14 Overlay/Agreement 2 Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use -A-6,1 Type of Construction A Residential Use Occupancy Group S.-2. Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: alUpdate Existing Mew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes INo Reason Sprinklers Required: "In Lieu"Fee:Type: Amos t$ Fire Alarm: VIUpdate Existing ONew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes INo Additional Notes: 'M l\ ,r neni— c ylh, — VALUATION CALCULATION: Total$ .4471 94* e`r"'r G or cips ., ` � 'fP'`y'¢"34 Approved By: 1c4efryil Date: 1Z 11—t 1 ("PUBLIC WORKS Intake OK by:"' Date: 12114 /201. Additional Notes: Intake Comments: IPWWorksheetNeededif: 1E`Z"e. -Ts I DSys Dev Eval ❑Traffic Mit Eval i4 -I' $ S CP o? '❑Site Work or Drainage Proposed Approved By: a Date: `/(� ❑Backflow Prevention for high hazard: GliP Y / i(dental,medical,animals,mortuary,hospital, isupportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) DFire Sprinklers El Fire Alarm DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: El This Permit is Approved by Public Works `' " ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑ A Separate PW Permit is Required(Permit#:PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 'ublic Works has no scope---PW Not R uired / Additional Note . /.,Q /9 /20/ 9 _ ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: V