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1 <br /> • t E NL PERMIT# \ — <br /> Intake &Approval Sheet (FOR PERMIT STAFFONLY) <br /> BUILDING PLANNING <br /> Intake OK b Date:l2 /`!, 7.0 %,(11C.P <br /> Intake OK b> SPAssign To: Date: `\, <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No.__ v 2` \\ ` <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 Cp -L ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size — Zone <br /> Number of Stories Overlay/Agreement <br /> Basement kNo ❑Yes, Fin/Unfin Nonresidential Use gtk\\e-\\KU e51,kXMo <br /> Type of Construction t(g Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load CO Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System 10Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: se r.,06 fl 44-1- "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System 64Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Ae 3-0O ' ,- 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 EONo Additional Notes: <br /> VALUATION CALCULATION: Total$ b to 2-4 <br /> Co-t k 14A- <br /> Approved �, Date: 'Z <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> '/ ❑Backflow Prevention for high hazard: <br /> Approved By: gb Date: /Li -�? <br /> j (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: IXThis Permit is Approved by Public Works <br /> IZI-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 /> gReview/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:(,a(,'jl,Ljn Date: 1/ "I tp [ ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: o <br /> i Aim 0 A <br /> ELECTRICAL qA)Z1 ,v6f <br /> Additional Notes: <br /> Approved By: Date: Approved By. /j-7 Date: 4/! /Zcr2Z.- <br />