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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) i PERMIT# Nt1'1d1- CS <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by;01/1 Assign To:1 'te>z R• Date: ' 2 l"i"J <br /> Intake Comments: Intake Comments: <br /> 0 <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ ute to Historic Reviewer <br /> ❑ Make this a"W"Permit lamOK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑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: ❑Update Existing ONew 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 School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 dots required prior to final? ❑Yes 0 No Additional Notes: <br /> VALUATION CALCULATION: Total$ /If /, Ob <br /> Approved By: j Date: —7- .202-4 <br /> PUBLIC WORKS,* <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: jPW Worksheet Needed if:: <br /> =DSys Dev Eval ❑Traffic Mit Eval <br /> :(]Site Work or Drainage Proposed <br /> Approved Date:m�f �/ OBackflow 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 /> El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />