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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • <br /> PERMIT#C-62-20S —ONO <br /> BUILDING PLANNING <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 /> Bldg/TI/Adem Sify) 0 Hold in Planning File Drawer <br /> Garage/Accessory 8truct.Size Aw Zone <br /> Number of Stories 2- Overlay/Agreement <br /> Basement ❑No' Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group rife.- Proposed No.of Dwelling Units: <br /> Occupancy Load 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: ❑Update Existing El New System ANot Req`d School Impact Fee: Total $ <br /> Reason Fire Alarm Required: 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 AiNo Additional Notes: AMCf ' :6190:..Q.IkArk.----, <br /> VALUATION CALCULATION: Total $(73 ao Le«) ('Q�%ouspgi, w/ <br /> Approved By: Y' Date: (0.2.22- <br /> BLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PWWorksheet Needed if: <br /> I DSys Dev Eval DTraffic Mit Eval <br /> I DSite Work or Drainage Proposed <br /> Approved By Datee�0 Z� OBackflow Prevention for high hazard: <br /> i(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: ❑ 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 0 Is in a Separate Green Folder (loin with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 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/PLUMBING <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: / <br />