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. -�1 <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) 4J <br /> PERMIT# FRZ207-flc5 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building 0 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 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: DUpdate Existing New System ❑NotReq'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: DUpdate Existing [hew System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: iPW Worksheet Needed if: <br /> jDSys Dev Eval ❑Traffic Mit Eval <br /> "Mite Work or Drainage Proposed <br /> Approved By: Date: ICIBackflow Prevention for high hazard: <br /> j(dental,medical,animals,mortuary,hospital, <br /> !supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end --- PW Review Worksheet <br /> Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review (Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 This Permit is Approved by Public Works <br /> 0 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 /> O Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder Qoin with this folder for permit issuance) <br /> 'eview/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:T,4 —c t Date:g/?j/Z Z ❑ 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 />