Laserfiche WebLink
i <br /> Intake &Approval Sheet W (FOR PERMIT STAFF ONLY) 411, PERMIT# h u' ICI Q Z'O <br /> BUILDING PLANNING� � <br /> Intake OK by: Date: Intake OK by: Assign To: '1/"I V/ J Date: ' <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building0 Attach to Project No. N G 'T-��'✓ J <br /> 1 <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 3e0 5A Zone 11-2, <br /> Number of Stories I Overlay/Agreement <br /> Basement INo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of.Construction II-g Residential Use Sr- <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 to <br /> Reason Sprinklers Required: "I ieu"Fee:Type: Amount <br /> Fire Alarm: El Update Existing•['New System ❑Not Req'd School I Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 'No ❑Everett School Di ❑Mukilteo I Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes N No Additional s: <br /> VALUATION CALCULATION: Total$ I Si 210 <br /> Approved By: 0.6 Date: 511 /2.0 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: "2,,0/ /iZ L Intake Comments: i PW Worksheet Needed if. <br /> I❑Sys Dev Eval OTraffic Mit Eval <br /> t <br /> DSite Work or Drainage Proposed <br /> Approved By: ( Date:a 1412, OBackflow 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 DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public Works : <br /> E(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 El Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder Qoin 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 SW 3p DFJV rea, <br /> Additional Notes: — / l <br /> Approved By: Date: Approved By: Date: �/1 /? ,6 <br />