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• 0 <br /> Q a <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# J� M "OSCt <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 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 1932, T-h'- 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories 2rr��-t,� Overlay/Agreement <br /> Basement El No L11Yes , Fi /Unfin Nonresidential Use <br /> Type of Construction V1E=. Residential Use <br /> Occupancy Group 'R. Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System IIINot Req'd Planning/Landscape Inspection Required before Final? ❑Yes"No <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing El New System tNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 121 No El Everett School Dist ❑Mukilteo School Dist <br /> Add]RCW 64.55 does required prior to final? ❑Yes 'No Additional Notes: <br /> VALUATION CALCULATION: Total$ 9 Co, Cvc,t) <br /> (�32= I l l a t- sea- Sn_-f-+ i <br /> 1ot32 n Itt ( �+ = Approved ByL--`�L.� Date: 7 7 - 2 t.' <br /> 1 Q 2&252o — <br /> `-\?j Zx `�O — Intake OK by: Date: <br /> Additional Notes: Intake Comments: 1PW Worksheet Needed if: <br /> IDSys Dev Eval ❑Traffic Mit Eval <br /> I OSite Work or Drainage Proposed <br /> Approved By: f�i Date:{j /�j�p ❑Backflow Prevention for high hazard: <br /> I (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 ❑Fire Alarm ❑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 0 Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 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: F1=Public Works has no scope PW Not Required <br /> Additional Note <br /> � 0S(2.4jZ, tu <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> GG' <br />