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34 Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#`2327°5.o2 <br /> BUILDING PLANNING p <br /> Intake OK by:/�=-�G�� Date: �G__ ,�e � Intake OK by:( j Assign To: e�li p, Date: V2-512-2. <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ oute to Historic Reviewer <br /> ❑ Make this a"W"Permit K to Route to Other Departments <br /> Bldg/TI/Add em` 'ze-> Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone lz I <br /> Number of Stories l Overlay/Agreement <br /> Basement ❑No . Yes, Fin nfin 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: El Update Existing ❑New System 'Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System aiNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? oyes rr No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes 'GLINo Additional Notes: <br /> VALUATION CALCULATION: Total$ 5/Oao <br /> Approved By: elt9 Date: t/ZS/ZZ„ <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PWWorksheet Needed if: <br /> j DSys Dev Eval ❑Traffic Mit Eval <br /> !Mite Work or Drainage Proposed <br /> �1 / �,�j� IDBackflow Prevention for high hazard: <br /> Approved By: �� Date: CP�(f�G�G'�vZ 1(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 /> OFire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 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 (join with this folderforpermit 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 4 Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL/PLUMBING <br /> Additional Notes: � StOc> e OSr98/7m7,I <br /> Approved By: Date: Approved By: Date: <br />