Laserfiche WebLink
0 ! <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# B i tdi — C=55 <br /> BUILDING PLANNING ,/ <br /> Intake OK by: Date: Intake OK b Assign To: Date LJ <br /> Intake Comments: Intake Comments: <br /> • <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 I/Addn/ m Size 2 Deb ,1 El Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size A/0 Zone IC&-- <br /> Number of Stories Z. - Overlay/Agreement <br /> Basement No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction C Residential Use =��(-hr �F k-.\ <br /> Occupancy Group Z/t-C Proposed No.of Dwelling Units: <br /> Occupancy Load /3 Total No.of Dwelling Units: <br /> Fire Sprinklers: El Update Existing ❑New System PNot Req'd Planning/Landscape Inspection Required be Final? ❑Yes %No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System ItNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes -121 No ❑Everett School Dist I ❑Mukilteo School Dist �1 <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes MNo Additional Notes: 4c).N i <br /> VALUATION CALCULATION: Total$ /� �. � <br /> D0 V\i V e l c `�� <br /> Art?� eN Co JCS\ C\-;O,,, <br /> Approved By: Date: ,,L <br /> PUBLIC WORKS <br /> Intake OK by: . Date: _ __ _ _ <br /> Additional Notes: Intake Comments: PW Worksheet Needed if:������_- -. -. <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By. . y Date: ��f Z' jam,_ <br /> ❑Backflow Prevention for high hazard: <br /> N/ (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> s 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 <br /> DCreate Green Folder ❑Sub n tted Previously ❑Deferred <br /> Additional Notes: LThis Permit is Approved by Public Works <br /> Vee PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: A Sell-ate PW Permit is Required(Permit#: PW Z.I OS_6 <br /> 26 <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: 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: ,t 7, 2ov2 <br /> ii <br />