Laserfiche WebLink
• <br /> • <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S Zt 0 7 - (x.33 <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> • a\t‘t 0A esT \i‘ <br /> ❑ 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 W., <br /> Number of Stories Overlay/Agreement OANc\ex\iit.& <br /> i <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <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: El Update Existing :New System ❑Not Req'd Planning/Landscape Inspection Required befor ' al? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: mount$ <br /> Fire Alarm: El Update 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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: <br /> > <br /> VALUATION CALCULATION: Total$4 a ' OO <br /> Approved Byr;/ Date: .Z 2dz <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: 1 <br /> 1PWWorksheetNeeded if: <br /> = Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> /+-„L_ �y�j� OBackflow Prevention for high hazard: <br /> Approved By /�G _ Date�T� v—"� _(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: OThis project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers El Fire Alarm ❑Other: 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 />