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52-10 8'-005 <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# E2i07"1213* <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"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: DUpdate 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: ❑Update Existing El New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes ❑ No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ /0 OM CO <br /> Approved By: Date: <br /> PUBLIC WORKS• <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: jPW Worksheet Needed if: <br /> 11:Sys Dev Eval ❑TrafficMit Eval <br /> /2///2074 I DSite Work or Drainage Proposed <br /> Approved B;� `,a� Date:.1/17.0d•zi DBackflow Prevention for high hazard: <br /> �% :(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate 1 Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ['Fire Sprinklers ['Fire Alarm ❑Other: AND I Create Green Folder OSubmitted Previously ❑Deferred <br /> Additional Notes: Y/This Permit is Approved by Public Works 1. • <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: Date: ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> T6 <br /> Additional Notes: <br /> Approved By: Date: Approved By: TJ Date: //z7/zo4 <br />