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0 <br /> Intake & Approval (FOR PERMIT STAFF ONLY)Sheet illPERMIT# <br /> BUILDING PLANNING <br /> Intake OK by: ` %� Date: el 6 /-' Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ee't.-"--4."4--- T,.,___H <br /> ❑ Route to Commercial Building El Attach to Project No. 1 <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer eg __-, <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 90 , F 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size WO Zone " - <br /> Number of Stories _ I Overlay/Agreement <br /> Basement glNo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction r2 Residential Use .0 ` (X <br /> Occupancy Group .,GC Proposed No. of Dwelling Units: cj‘At <br /> Occupancy Load S Total No. of Dwelling Units: \\k),Q) <br /> Fire Sprinklers: ❑Update Existing ❑New System IgNot Req'd Planning/Landscape Inspection Required before Final? DYes No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: DUpdate Existing ❑New System 1) Not Req'd School Impact Fee: Total $ _f <br /> Reason Fire Alarm Required: Calculated: F Credit: ,-_— <br /> RCW 64.55 MF worksheet req'd for permit? DYes Tin No DEverett School Dist t 1Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? DYes tiNo Additional Notes: <br /> VALUATION CALCULATION: Total$ i i1 71 o0 <br /> "ki. <br /> Approved B Date: ‘' 2OI___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 /> DSite Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved B Datedyalz/Zori (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 /> DFire Sprinklers ❑Fire Alarm DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: S1 is Permit is Approved by Public Works <br /> LY See PW Review Worksheet and associated attached it items s <br /> Fire Dept. Fees: ❑A Separate PW Permit is Required (Permit#: PW ) <br /> El 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(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: 7/404 <br /> pp pp � <br /> e <br />