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• <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# 22-OZ <br /> BUILDING 2.. PLANNING • • . " <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 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 . p N.42).YeltV <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 ❑Not Req'd Planning/Landscape Inspection Required .- ore Final? ❑Yes ❑No <br /> Reason Sprinklers <br /> Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: I13IUpdate Existing ❑New System ❑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 II No ❑Everett School Dist 7 ❑Mukilteo School Dist <br /> Add'I RCW 64.55 doss required prior to final? ❑Yes tijNo Additional Notes: <br /> VALUATION CALCULATION: Total$ .4i z <br /> Approved• <br /> PUBLIC WORKS` <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> iDSys Dev Eval DTraffic•Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved B ! Date•007/70ZZ_ '❑Backflow Prevention for high hazard: <br /> :(dental,medical,animals,mortuary,hospital, <br /> _supportive housing) <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 /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public Works a • <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 A Separate PW Permit is Required(Permit#: PW <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND 0 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved B Date:aspV262. _ ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By Date: 3 A 3 t d 2....cr7,-L <br /> V <br />