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Intake & Approval Sheet 10(FOR PERMIT STAFF ONLY a PERMIT #_ SAA 06-1015 <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" rmit <br />Bldg/TI/Add em Size <br />Garage/Accessory tract. Size <br />Number of Stories <br />Basement <br />%No ❑Yes , Fin / Unfin <br />Type of Construction <br />03 <br />Occupancy Group <br />Occupancy Load <br />9 <br />Fire Sprinklers: ❑Update ExistlnglqNew System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing <br />gNew System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes ipNo <br />VALUATION CALCULATION: Total CPI, VW <br />�7�t,51°1 <br />Additional Notes: <br />Approved By Date: Ot 2 � 1w 3 <br />FIRE DEPARTMENT <br />Separate I Deferred Submittals Required: <br />❑Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />EIAA!nimal or No Fire Scope - NO FIRE FEE <br />Review / Inspection Scope - ADD FIRE FEE <br />Approved By: AGA ftf 1< (3 Date: j l g 2 Z <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Assign To: Date: <br />Intake Comments: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use . <br />Residential Use <br />Proposed No. of Dwelling Units. - <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukiiteo School Dist <br />Additional Notes: <br />Approved By: 1� Q 0 Date: �Z L y i✓ <br />PUBLIC WORKS <br />Intake OK by: Date: .—a42-�Z`'-ZZ .,... ............. _....... <br />Intake Comments: {PW Worksheet Needed if,- <br />[]Sys Dev Eval ❑Trafiic'Mit Eval <br />❑Site Work or Drainage Proposed <br />_ �.Jo i► W �i:.i_�E7 <br />❑Backflow Prevention for high hazard: <br />? (dental, medical, animals, mortuary, hospital, <br />supportive housing) <br />❑Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND [Create Green Folder []Submitted Previously ❑Deferred <br />❑ This Permit is Approved by Public Works � <br />❑ See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folderfor permit issuance) <br />❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: % Date: I g Z Z <br />i <br />