Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S tO, ®(n'001 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: (.e/ f r <br /> Intake Comments: Intake Comments: Assign To: /i <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ ':ute to Historic Reviewer <br /> ❑ Make this a"W"Permit IPA OK to Route to Other Departments <br /> BldglTI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone G- J Ili U O <br /> Number of Stories Overlay/Agreement _--_� ` q— <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use I-&44 `q --f ew <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? DYes ONo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing El 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 ❑ 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$ 4'VD_MO <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> Mite Work or Drainage Proposed <br /> Approved B Date:f 0 /24 ❑Backflow Prevention for high hazard: <br /> `/ (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute 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 DFire Alarm DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <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: ❑ 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_ <br />