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• B?.V 7-5to✓r Su <br /> Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# CAir ty� <br /> Z Z®2 —Qo 3 <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 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 <br /> Number of Stories Overlay/Agreement <br /> Basement ONo ❑Yes, Fin/Unfin Nonresidential Use . <br /> Type of Construction • Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load 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 ONot 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 DMukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: <br /> PUBLIC INORKSf" <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: #PW Worksheet Needed if. <br /> iDSys Dev Eval DTraffic Mit Eval <br /> • 'Mite Work or Drainage Proposed <br /> Approved By: Date: ;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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND OCreate 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: ,`i n Date:5 � ❑ Public Works has no scope---PW Not Required <br /> Additional Notest-tir µ4, r{,w..,c4. Pa4VC.o 4-I'$I1l-- <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: 513/1..o /-L, <br />