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• 0 evoo(4 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# <br /> BUILDING PLANNING �/ <br /> Intake OK by: Date: ZA/Zd Intake OK by:_�_ Assign To: [ f/JDate:2,/4/2g20 <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> El Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bld /TI/Addn/Rem Size Hold in PlanningFile Drawer <br /> 9 <br /> Garage/Accessory Struct.Size Zone - g--1 <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use . <br /> Type of Construction ' 6 Residential Use <br /> Occupancy Group R Proposed No.of Dwelling Units: -- <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: El Update Existing ❑New System FINot Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo <br /> Reason Sprinklers Required: "In Lie " ee:Type: mount$ <br /> Fire Alarm: El Update Existing El New System KNot Req'd School Impact Fee. otal $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? • ❑Yes `� No ❑Everett S of Dist ❑Mukilteo I Dist <br /> . Add!RCW 64.55 docs required prior to final? ❑Yes No Ad ' ' nal Notes: _I/1 I f 0..�v�r �cr/ _ . No atv <br /> iis <br /> VALUATION CALCULATION: Total$ 30 i oD o T <br /> to- G*-r cr. <br /> Approved By: M Date: 2/4-/22e <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Zo 5 , c 0 f sec. Intake Comments: !PW Works he et Needed if: <br /> DSys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: 'd44Date:'ZiggZ,O =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 /> El 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 0 Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder coin 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 /> /Z— <br />