Laserfiche WebLink
0 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) 0 PERMIT 1/7iO'3- ©CO D <br /> # <br /> BUILDING PLANNING <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 ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone 0`) <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction t'Jle Residential Use P(I 4) Y2— <br /> > <br /> Occupancy Group 2W-e Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: ( , <br /> Fire Sprinklers: El Update Existing El 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: El Update Existing ❑New System Not Req'd School Impact Fee: Total $ - <br /> Reason Fire Alarm Required: ZCalculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 does required prior to final? ❑YesNo Additional Notes: 1 11p/c <br /> VALUATION CALCULATION: Total$ Z aL406 1�"�' � � �� <br /> Approved By: Date: (`',� Z <br /> 2 <br /> BLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> OSys Dev Eval OTraffic Mit Eval <br /> Osite Work or Drainage Proposed <br /> Approved B Date mrf/J tZ ElBackflow Prevention for high hazard: <br /> / :(dental,medical,animals,mortuary,hospital, <br /> _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 ❑Deferred <br /> Additional Notes: ❑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 /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 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 /> 21Z <br />