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• • <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# gz\ i � azi <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 ❑ oute to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bidg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone L. j Z <br /> Number of Stories Overlay/Agreement <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use 1.J 1M4. 6 <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 ONew System ❑NotReq'd Planning/Landscape Inspection Required before Final? ❑Yeo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El 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? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: IPWWorksheet Needed if: <br /> OSys Dev Eval ❑Traffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> Approved By: <br /> Lj Date: `� <br /> OBackflow 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/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ODeferred <br /> Additional Notes: ❑This 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 ❑ 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: F1Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL ` /2 /gyp/ZOZ' <br /> Additional Notes: i <br /> Approved By: Date: Approved By: Date: <br />