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Intake &Approval Sheet 410 (FOR PERMIT STAFF ONLY) • PERMIT# F 2-2-oz -0 <br /> BUILDING PLANNING" • . • . • ' <br /> Intake OK by:_ — Date: Intake OK by: .I ,_ Assign To: Date:2/17/7 <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make th's a"W"Permit ❑ OK to Route to Other Departments <br /> Bidg/T 'dd. •em Size t 70 1 eLAJ ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone `2-' <br /> Number of Stories Overlay/Agreement <br /> Basement kiNo�y� 'es, Fin/Unfin Nonresidential Use <br /> Type of Construction GJ - — Residential Use F lZ .. <br /> Occupancy Group cfkir Proposed No.of Dwelling Units: . <br /> Occupancy Load �/ Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System Mot 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 Mot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Er <br /> Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes n No Additional Notes: <br /> VALUATION CALCULATION: Total$ OV� <br /> Approved Br-Am X CMggx(yloc< Date: 2/1 .l� <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 /> • <br /> . / � ❑Site Work or Drainage Proposed. <br /> Approved By:(1 Dater/ � p�� 1l]Backflow Prevention for high hazard: <br /> JJJ (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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: :1.1 ❑This Permit is Approved by Public Works . 3 <br /> 0 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 />