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Intake & Approval Sheet 0 (FOR PERMIT STAFF ONL19 • PERMIT#??i`i✓ 1 / ;L' 9 -' <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK b Assign To. <br /> l� t <br /> �' 9 ��r�� Date:11-d� <br /> Intake Comments: Intake Comments: 111 <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ M this a"W" Permit El OK to Route to Other Departments <br /> Blde„) <br /> ddn/Rem Size & 0O /4Lr'-u-' ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size — Zone — <br /> Number of Stories ( Overlay/Agreement <br /> Basement NNo ❑Yes , Fin/Unfin Nonresidential Use _ <br /> Type of Construction 2,77 -- Residential Use c`(< <br /> Occupancy Group ,-Z-% Proposed No. of Dwelling Units: <br /> Occupancy Load n/if'1 Total No.of Dwelling Units: di\e_ <br /> Fire Sprinklers: ❑Update Existing ❑New System EiNot Req'd Planning/Landscape Inspection Required before F,'nal? ❑Yes 'No <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: ' • ount$ <br /> Fire Alarm: ❑Update Existing ❑New System ONot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes CI No El Everett School Dist ■Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes ❑'No Additional Notes: <br /> VALUATION CALCULATION: Total $ a rJi <br /> Approved Bye '? Date: VZ ,\S t- i <br /> l PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: /J ❑Backflow Prevention for high hazard: <br /> pp � �� Date: ����f�; (dental,medical,animals,mortuary,hospital, <br /> 6 :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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items /VIA} <br /> Fire Dept. Fees: 0 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 /> A ditional Notes: <br /> ELECTRICAL f� j' v, p` <br /> Additional Notes: I't� f n f .v dr/ 'v o 64 S�PG 7.",'` <br /> Approved By: Date: Approved By: Date: :1(5/Zp <br /> .2—`y <br />