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Intake &Approval Sheet I (FOR PERMIT STAFF ONLY) • PERMIT# 'Ifia0 —003 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this "W"Permit CI OK to Route to Other Departments <br /> BI UAdd /Rem ize H`f ,S'F ❑ Hold in Planning File Drawer <br /> arage/ cessory Struct.Size Jr Zone u IA <br /> Number of Stories / Overlay/Agreement <br /> Basement :No Oyes , Fin/Unfin Nonresidential Use <br /> Type of Construction Vfl Residential Use <br /> Occupancy Group a Proposed No.of Dwelling Units: <br /> Occupancy Load 2 Total No.of Dwelling Units: <br /> Fire Sprinklers: El Update Existing El New System pNot Req'd Planning/Landscape Inspection Required before Final? YesNo <br /> Reason Sprinklers Required: / "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑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? oyes ,'No El Everett School Dist ❑Mukilteo School ist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ,No Additional Notes: A ex5 of-- plan ; <br /> VALUATION CALCULATION: Total$ FOO 00 f0J .a( l.p taw Ar4 1e66\ �� <br /> Approved By: V2, /vl, Date: IX.6.z,a-to <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: !PW Worksheet Needed if: <br /> 'DSys Dev Eval ['Traffic Mit Eval <br /> i USite Work or Drainage Proposed <br /> Approved B Date:/�/z,2. I DBackflow Prevention for high hazard: <br /> :(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 El 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: Pie Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: INA Date: It 11" to <br />