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• <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# 2207/'01) <br /> BUILDING - PLANNING' • . •-• • - <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <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 /> BIdglTl/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . <br /> Type of Construction - Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load • Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ONew System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: DUpdate Existing New System QNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes RI No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: <br /> VALUATION CALCULATION: Total$ 3G11 ewv <br /> Approved By: Date: 2.10 7,Z <br /> UBLIC WORKS"- <br /> Intake OK by: Date: <br /> Additional Notes: scam lss�t41e.r•.etrc. t Intake Comments: JPW Worksheet Needed if: <br /> El Sys Dev Eval ❑Traffic'Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: ,$ Date: 211t/�, � ;�Backflow 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 OFire Alarm DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ppby <br /> his Permit is Approved 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 ❑ 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 Bq- Date: Lb(/2022 <br />