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11110 <br /> s <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 6 7-20 - 001 <br /> BUILDING ////���� PLANNING <br /> Intake OK by: Date: Intake OK by: U"16 Assign To:it taxf Date: ✓«L.Z_ _ <br /> Intake Comments: Intake Comments: <br /> • <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ '•ute to Historic Reviewer <br /> ❑ Make this a"W"Permit Fa OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size .4. 2 ■ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size — Zone <br /> Number of Stories Overlay/Agreement <br /> Basement INo DYes, Fin/Unfin Nonresidential Use <br /> Type of Construction V "2 Residential Use <br /> Occupancy Group le> Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: t3Update Existing El 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: El Update Existing El 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 51 No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add]RCW 64.55 does required prior to final? ❑Yes 1-g No Additional Notes: <br /> VALUATION CALCULATION: Total$ �j ener, <br /> Approved By: v e Date:3, Z.22 <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> DSys Dev Eval ❑Traffic Mit Eval <br /> IDSite Work or Drainage Proposed <br /> Approved By: Date: <br /> / IDBackflow Prevention for high hazard: <br /> =(dental,medical,animals,mortuary,hospital, <br /> _supportive housing) <br /> FIRE DEPARTMENT DRoute 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 DFire 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 /> El-Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:' 31 rj(Ny Date: a,I = ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> zil� <br />