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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) . PERMIT# v2-I( 0—DOS <br /> BUILDING . , PLANNING Intake OK by: Date: Intake OK by: 6rje7 Assign To: AtagI• Date: IO126ll l <br /> Intake Comments: Intake Comments: <br /> e <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit Al4 OK to Route to Other Departments <br /> Bldg/Tl/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone V <br /> Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use WIC s -Pad 1iit/,� <br /> Type of Construction Residential Use U <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ONot 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 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 El Everett School Dist ❑Mukilteo School Dist <br /> Add'i RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total$2S ,r� <br /> Approved By: AL Date: (6/24/Obi"( <br /> PUBLIC WORKS'' <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: #PW Worksheet Needed if: <br /> DSys Dev Eva! DTraffic Mit Eval <br /> • <br /> . IOSite Work or Drainage Proposed <br /> Approved B Dat /O Zd✓/ ;l]Backflow Prevention for high hazard: <br /> / _(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE DEPARTMENT 0 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 OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: .; ❑This Permit is Approved by Public Works <br /> 0 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 /> 0 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 /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 2/7-- <br />