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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# )1 1 1 --VL\ \ <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 /> BI I/ ddn/Rem Size / 6� El Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size 4//.� Zone <br /> Number of Stories / Overlay/Agreement <br /> Basement EiNo ❑Yes, Fin/Unfin Nonresidential Use / <br /> Type of Construction ,u--,Q Residential Use 7 <br /> Occupancy Group F-I/B/N-(/S-/ Proposed No.of Dwelling Units: / <br /> Occupancy Load A. Total No.of Dwelling Units: ,/ <br /> Fire Sprinklers: DUpdate Existing INew System El Not Req'd Planning/Landscape Inspe'dction Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: r1�a "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing 12INew 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 Sc of Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional tes: <br /> VALUATION CALCULATION: Total$ 6 Si7j Piz 00 <br /> \NO- 1\qcli cuLt xvki-vit‘ 1 6(0 <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if:: <br /> DSys Dev Eval ❑Tr-''c Mit Eval <br /> Approved By. j� <br /> ❑Site Work or Drai.Age Proposed <br /> Date: _❑Backflow Pr---ntion for high hazard: <br /> ((dental,medi.:,animals,mortuary,hospital, <br /> isupportive ousing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at e'i ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate oncurrent PW Review(Green Folder) <br /> .Fire Sprinklers Fire Alarm ❑Other: AND ❑Create Green Folder M Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approve. .y Public Works <br /> ❑ See PW Review W. sheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separate PW 'ermit is Required (Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is to :.led in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ I n a Separate Green Folder(join with this folder for permit issuance) <br /> Review/Inspection Scope-ADD FIRE FEE i Will be issued separately(Se Green F PW issued ahead of Bldg) <br /> Approved By: K,B w fl Date: /�_/7_ /9 ❑ ' blic Works has no scope--- W Not Required <br /> 6 ional Notes: <br /> ELECTRICAL UJ'� ����' c1 '(1 <br /> Additional Notes: <br /> , iit <br /> Approved By: Date: Approved By: Date: <br /> 4 , <br />