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Intake &Approval Sheet (FOR PERMIT STAFF ONL PERMIT# 2- 7-0� Z <br /> AP ONLY) <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: 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 ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size A 0 /A ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size _. Zone <br /> Number of Stories / Overlay/Agreement <br /> Basement EfNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction f`I -"Q Residential Use <br /> Occupancy Group c--/ Proposed No.of Dwelling Units: <br /> Occupancy Load j//f A Total No.of Dwelling Units: <br /> Fire Sprinklers:CI Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: dUpdate Existing ❑New 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? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 dots required prior to final? Oyes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ 2O J 000 <br /> 03 <br /> Approved By: INN Ij V Tate: . <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> l�G--� 3 4„ 6" OSys Dev Eval ❑Traffic Mit Eval <br /> �4 `Sd OSite Work or Drainage Proposed <br /> [0, OBackflow Prevention for high hazard: <br /> Approved By: 1 , Date: <br /> :(dental,medical,animals,mortuary,hospital, <br /> !supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet W�n <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 ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by Public Works <br /> ❑ 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 /> ❑ 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 /> ' Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 4 <br />