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Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) 0 PERMIT# 5 ZZC7/--W6 <br /> BUILDING .•" " PLANNING /L" <br /> Intake OK by: Date: Intake OK by: Assign To: 'W1�pp . Date: �ll�`22 <br /> Intake Comments: Intake Comments: / <br /> % <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 Ro 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 (Z2-- <br /> Number of Stories Overlay/Agreement stq .&l-f- $ <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . �J <br /> Type of Construction • Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load 0 Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ONew 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 El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: , Date: 4' /?ppZZ <br /> PUBLIC WORKS' <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: DPW Worksheet Needed if: <br /> DSys Dev Eval DTraffic Mit Eval <br /> •• i❑Site Work or Drainage Proposed <br /> Approved By: Date: *lax 12132g... ;(]Backflow Prevention for high hazard: <br /> _(dental,medical,animals,mortuary,hospital, <br /> �C ;supportive housing) <br /> _ FIRE DEPARTMENT El 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 ['Fire Alarm El 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 /> 2—J2_, <br />