Laserfiche WebLink
Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT#V 2067 — 0(0 3 <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 V l <br /> Number of Stories Overlay/Agreement F-€ u , <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use 90)\ i s <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 ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Jo <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: ai‘,/\\15 -" 9�. qP` <br /> VALUATION CALCULATION: Total$ a�06a of t i,.h 1 >s'C-�' '�3 b;At `VTrF,+�— a.lYjct&ct,A— <br /> W s ; o a,P,\i".wl 5c,„ee-n et i f "eke— <br /> Approved By: 14..: Date: aJ— I R—tow <br /> w <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =pWWorksheetNeededif: <br /> `DSys Dev Eval ❑Traffic Mit Eval <br /> °Site Work or Drainage Proposed <br /> Approved B,fA`,t. Date:p/6Z,ZD� =OBackflow Prevention for high hazard: <br /> ;(dental,medical,animals,mortuary,hospital, <br /> 'supportive housing) <br /> FIRE DEPARTMENT El 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 El Fire Alarm lgOther: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: El This Permit is Approved by Public Works <br /> Kr( cc \ c€(t V\ El 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 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: c 66-7jGJ(1 Date:3-- , El Public Works has no scope---PW Not Required <br /> 7- .2D Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> z <br />