Laserfiche WebLink
Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLY) • PERMIT # � U) )� 0 _2,cc' <br />BUILDING <br />Intake OK by: Date: I� <br />Intake Commen . <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg Addn/Rem Size <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />WNo ❑Yes , Fin / Unfin <br />Type of Construction <br />3— <br />Occupancy Group <br />Occupancy Loa <br />30 <br />Fire Sprinklers: Update Existing ❑New System El Not Req'd <br />Reason Sprinkl s Required: <br />Fire Alarm: IpUpdate Existing ❑New System ❑Not Req'd <br />Reason Fire Alarm Required: d,s e / �c15� uat <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes <br />RI No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes <br />®No <br />VALUATION CALCULATION: Total $ L Isp <br />Additional Notes: <br />!Approved By: Date: �p <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />Eire Sprinklers MFire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />❑ Minimal or No Fire Scope - NO FIRE FEE <br />Review / Inspection Scope -ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Date: <br />Intake Comments: Assign To: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />El Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: <br />IVIA- <br />,Approved By: Date: <br />PUBLIC WORKS <br />Intake OK by: Date: <br />----------------------------------------- <br />I ntake Comments: ; PW Worksheet Needed if.• <br />❑Sys Dev Eval ❑Traffic Mit Eval <br />❑Site Work or Drainage Proposed <br />1113ackflow Prevention for high hazard: <br />'(dental, medical, animals, mortuary, hospital, <br />:supportive housing) <br />❑Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />❑ This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) <br />kAdd <br />❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />Public Works has no scope --- PW Not Required <br />final Notes: <br />Approved By: Date: <br />Z/� <br />