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• • <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#W2-1 11 D32- <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ , ach to Project No. <br /> ❑ Route to Residential Building I Route to Historic Reviewer <br /> ❑ M e this a"W"Permit tI OK to Route to Other Departments <br /> BI 6I/A do/Rem Size ■ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone tAK"3 <br /> Number of Stories Overlay/Agreement <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use V'4 F <br /> Occupancy Group 2Z.- Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑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: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ - <br /> Reason Fire Alarm Required: IN <br /> Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? IctYes ❑ No El 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$ 5����da <br /> ( ( •It.2( <br /> Approved B 0 \. Date:`4„� <br /> PUBLIC WORKS <br /> Intake OK by: . Date: _ <br /> Additional Notes: Intake Comments: PW Worksheet Needed if:..v._. <br /> ; Sys Dev Eval ❑Traffic Mit Eval <br /> DSite Work or Drainage Proposed <br /> Approved B Date: Urz 67L OBackflow Prevention for high hazard: <br /> ;(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> FIRE DEPARTMENT El 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 /> OFire Sprinklers ❑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 ElWill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved Byr\(---,� j(a 4-0(, Date: \\-1(tt C3_ L\ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: 172 <br /> Approved By: Date: Approved By:zA 6 f Date: II <br /> 12P21 <br />