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• • <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S 21 OZ— 00/ <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> El Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ 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 Zone by <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Y-s , Fin/Unfin Nonresidential Use , rQ, ,li0.,nA.. <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 Exi ing ❑New System El Not Req'd Planning/Landscape Inspection Required before inal? ❑Yes [TNo <br /> Reason Sprinklers Requir-d: "In Lieu" Fee: Type: Am unt$ <br /> Fire Alarm: ❑Up..te Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alar 'equired: Calculated: Credit- <br /> _ <br /> RCW 64.55 MF ..rksheet req'd for permit? El Yes 0 No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RC i :4.55 docs required prior to final? ❑Yes ❑No Additional Notes: c O\� Ca, Q- <br /> VALUATION CALCULATION: Total$ //J �7� V J �1 ✓ / ` <br /> Approved By: . . izk <br /> 'Z 1 b_Z J <br /> BLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> J <br /> Approved By: Date: ©"`�!/ r/7 =❑Site Work or Drainage Proposed <br /> / / / ❑Backflow Prevention for high hazard: <br /> I(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 /> ❑Fire Sprinklers ❑Fire Alarm DOther: AND El 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: 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />