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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) 0 PERMIT# RIZ-2-°11 ,-O`'"1( <br /> BUILDING PLANNING . • - " <br /> Intake OK by: Date: Intake OK b Assign To: Date: //1//27i <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building 0 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 1-I y <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . 414041'a 0 ( --Fo a <br /> Type of Construction - Residential Use UU _ <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load • • Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El 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? ❑Yes ® No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'i RCW 64.55 does required prior to final? oyes RI No Additional Notes: <br /> VALUATION CALCULATION: Total$�0.0i LIDO <br /> . � b Mit& (Thysi,.9 Li/igI72 <br /> Approved By: Date: <br /> PUBLIC WORKS' <br /> Intake OK by: Date: <br /> Additional Notes: K cgc7V . .`-',*(149IL ,=04•Y Intake Comments: 1PWWorksheetNeededif:: <br /> IDSys Dev Eval ❑Traffic Mit Eval <br /> • <br /> IDSite Work or Drainage Proposed <br /> Date: ,d, IDBackflow Prevention for high hazard: <br /> Approved By: <br /> �d� 1(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 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: 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 /> ZIt% <br />