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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) Ill PERMIT# E2...106 <br /> 2J06 - O f 6 <br /> BUILDING PLANNING <br /> Intake OK by:, /I Date: 0 •Z,7/ Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> 0 Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI dd em Size II q(o 2 fti" ❑ Hold in PlanningFile Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories Overlay/Agreement %\1eSSAt ti Q <br /> Basement JNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use SC< <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: OAQ, <br /> Fire Sprinklers: ❑Update Existing ONew System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes INo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: A • <br /> Fire Alarm: ❑Update Existing ONew System lNot 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 docs required prior to final? ❑Yes Q No Additional Notes: <br /> VALUATION CALCULATION: Total$ 239/3 3 8 <br /> \\ -V). ZOZl <br /> Approved B • <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: ArpeoVEfl /iS Ill o re-P Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> g <br /> r� ❑Backflow Prevention for high hazard: <br /> Approved By: F-g_ Date: /O/21/202 I <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 ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: WThis Permit is Approved by Public Works <br /> ICI ee PW Review Worksheet and associated attached ite s <br /> Fire Dept. Fees: A Separate PW Permit is Required (Permit#: PW 740C' <br /> p "UJ <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND 1Is located in this folder <br /> -Minimal or No Fire Scope-NO FIRE FEE 0 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: 93roujc\ Date: -?,q c 2.\ ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: 1 Date: 7Aill()Z1 <br />