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• <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S2_\ 07_ — 005 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:4 Assign To:9Ly Date: Jam/j J2i7-1 <br /> Intake Comments: Intake Comments: <br /> CQ(KAVn / / oi . <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> O Route to Residential Building ❑ oute 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 L <br /> Number of Stories Overlay/Agreement S�.c� A C ci <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 El New System ❑NotReq'd Planning/Landscape Inspection Required before Final? DYes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing El New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add]RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total $ elS—C) <br /> • <br /> Approved By: ( Date: ? /i_iiz_-1 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> IDSys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: i_.Ls' Date: 1 j I❑Backflow 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 /> OFire Sprinklers El Fire Alarm El Other: AND El Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 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 /> O 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 /> 1 �� <br />