Laserfiche WebLink
Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) ! PERMIT#S62o7, r07 5 <br /> < t <br /> BUILDING PLANNING <br /> Intake OK by: Aid, Date: i 9 a02-19 Intake OK by: Assign To: Date: <br /> Intake Comm: Intake Comments: <br /> sis6e.\‘ EI \NZn ek.n.z o.zt-ko�ge to-5— <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 i-{"' ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size C- Zone <br /> Number of Stories — Overlay/Agreement <br /> Basement Ojallo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction \i(1J Residential Use <br /> Occupancy Group li Proposed No.of Dwelling Units: <br /> Occupancy Load -- Total No.of Dwelling Units: <br /> Fire Sprinklers: El Update Existing El New System INot Req'd Planning/Landscape Inspection quired before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing El New System Not Req'd School Impact Fee: Tot $ <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$ (ate. OO QQ\e-S 'M+,1�Sa 'OE l '`�-� OA-SNe c%&c U\@s'c k A 1'V t <br /> ,p‘A\OMc. roc - n wGY <br /> Approved By:c----1 ) Date: 2.\9,2 O ZO <br /> PUBLIC WORKS <br /> Intake OK by:`T'� Date: '2`/ 9 'ZDZ® <br /> Additional Notes: Intake Comments: IPWWorksheetNeeded if: <br /> F6i S r„, .$� 1At A.L i Sys Dev Eval OTraffic Mit Eval <br /> c., -"Pz,v*17 --elc.arY .r-t jElSite Work or Drainage Proposed <br /> Approved By: Date: ..b/Qo.� RED "1�T , 2,oNg =OBackflow Prevention for high hazard: <br /> t :(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: M,This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: El Separate PW Permit is Required(Permit#: PW ) <br /> `Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> gReview <br /> Minimal or No Fire Scope NO FIRE FEE ❑ Is in a Separate Green Folder join with this folder forpermit issuance) <br /> P U <br /> ❑ Review/Inspection ope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> 1 <br /> Approved By:�� Date: V2 --re,,e7 ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved by., R Date:21/5/Z-A 24, <br /> Z4_ <br />