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0 0 <br /> k Approval PERMIT STAFF ONLY) PERMIT# ' `��Int <br /> ake e & Sheet (FOR <br /> BUILDING PLANNING <br /> Intake OK by:A,A Dater 27V 46 21 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 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 3/82— 5 .r. ElHold in Planning File Drawer <br /> _ <br /> 6v '3 <br /> Garage/Accessory Struct. Size C j. t' _ Zone !.� <br /> Number of Stories 2- _ Overlay/Agreement <br /> Basement No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction14a-t-- Residential Use f CLeil z,FS2- <br /> Occupancy Group _ Proposed No.of Dwelling Units: f <br /> Occupancy Load ��77.�� Total No.of Dwelling Units: i <br /> Fire Sprinklers: ❑Update Existing ❑New System I�Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes .QNo <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing ONew System ❑Not Req'd School Impact Fee: Total $ �UH< <br /> Reason Fire Alarm Required: Calculated: )Oh14) Credit: <br /> RCW 64.55 ME worksheet req'd for permit? ❑Yes 'No El Everett School Dist ./lukilteo School Dist //�� <br /> Add'I RCW 64.55 docs required prior to final? Yes 'No Additional Notes: - r 1 1 <br /> VALUATION CALCULATION: Total$ 00 UQ CJ 4' of- <br /> Approved By: .1A.4,2igi Date: t it 17 a <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 /> CI Site Work or Drainage Proposed <br /> Approved By ,4, Date: 1//SJ � ❑Backflow 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 /> El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ODeferred <br /> Additional Notes: 0 This Permit is Approved by Public Works <br /> Q See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: A Separate PW Permit is Required (Permit#: PW�? r) )~- 0 (<]� <br /> ) <br /> o Review of As-Built Plans-NO FIRE FEE AND El Is located in this folder (� <br /> 13 Minimal or No Fire Scope-NO FIRE FEE EKin a Separate Green Folder(join 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: ,13a,LA/n Date:&, 9 2/ ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: a 1 Date: / 2O2J <br /> (.7 <br />