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4P 110 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONL19 PERMIT# 8 z-t°I - o p a <br /> BUILDING r!'� PLANNING / <br /> Intake OK by: Date: Intake OK by: Assign To: 11�1 - Date: /O/ 7/UZI <br /> Intake Comments: Intake Comments: I <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Mke this a"W"Permit to Route to Other Departments <br /> Blkg/TI/ ddn/Rem Size 2 /30 s"J ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size .4/1/44 Zone f <br /> Number of Stories / Overlay/Agreement <br /> Basement INo¢¢ ❑Yes , Fin/Unfin Nonresidential Use Ch li l opraC4fC OW O_ <br /> Type of Construction �K3 Residential Use <br /> Occupancy Group /J Proposed No.of Dwelling Units: <br /> Occupancy Load 39. Total No.of Dwelling Units: <br /> Fire Sprinklers:,' Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: jaupdate Existing ❑New 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 12 No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes )21,No Additional Notes: <br /> VALUATION CALCULATION: Total$ S J LSD,Da <br /> Approved By: at> Date: Id f-i /i"1 <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 /> i <br /> `OSite Work or Drainage Proposed <br /> Approved By Date: i�/p 9perzt -LIow Prevention for high hazard: <br /> _(dentaenta medical,medical,animals,mortuary,hospital, <br /> !supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Se•arate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> r4C ire Sprinklers ilarire 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 0 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 /> U Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:\<,elc-OLAin Date: '0-- 1:4'ublic Works has no scope---PW Not Required <br /> Additional Notes 'o k+ Z.'to ' <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />