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• 0 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# B��✓ `r8v� <br /> (.� BUILDING PLANNING <br /> Intake OK by? /t- Dated 2'hell Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> '\$cis ems\. o� \k e \� <br /> u* 64'44 % <br /> o Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br />• <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 S&--� <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction 2=44 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 JNot Req'd Planning/Landscape Inspection Re•.tred before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing El New System 6Not Req'd School Impact Fee: Tota <br /> Reason Fire Alarm Required: rr�I Calculated: Credit: <br /> ❑ g RCW 64.55 MF worksheet req'd for permit? Yes No ❑Everett School I• t ❑Mukilteo School Dist <br /> Add]RCW 64.55 docs required prior to final? ❑Yes ANo Additional Notes. <br /> VALUATION CALCULATION: Total$,aoa 00 <br /> Approved B Date: q_\L\. Mt\ <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: Pw worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved B Date:orz f ❑site W w Prevention for high hazard: <br /> f/ ;(dental,medical,animals,mortuary,hospital, <br /> _supportive housing) <br /> FIRE DEPARTMENT DRoute 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by Public Works <br /> 0 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: tYl ublic Works has no scope---PW Not Required <br /> — _ Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: o R e [Zo 21 <br /> Approved By: Date: Approved By: Date: <br />