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• <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Qo�o2 O8 i O-p'# <br /> BUILDING PLANNING" • • • • . <br /> • <br /> • <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 /> BldgfTI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No Ekes, Fin/Unfin Nonresidential Use <br /> Type of Construction (/,4 Residential Use <br /> Occupancy Group R--Z Proposed No.of Dwelling Units: <br /> Occupancy Load • • Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing Chew 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 ❑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? EYes El No No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑ p <br /> Yes - No Additional Notes: ��C�,,�"o/d.r1 <br /> VALUATION CALCULATION: Total$67/f 7`'7 J <br /> Approved By: 1U Date: 1 d Y• <br /> ZZ <br /> PUBLI WORKS` <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: :!PW Worksheet Needed if: <br /> ?LISys Dev Eval ❑Traffic'Mit Eval <br /> DSite Work or Drainage Proposed. <br /> Approved By:Z Date: a.� .92�zz!� ❑Backflow Prevention for high hazard: <br /> / ;(dental,medical,animals,mortuary,hospital, <br /> isupportive 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 ❑Fire Alarm ❑Other: AND ❑Create 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: 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 /> 4 <br />