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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT# PI 0 7 060
<br /> BUILDING - . ,.. PLANNING PLANNING . • • ^�. J�
<br /> Intake OK by: Date: Intake OK 1315q Assign To: Date: 7/2// 2 -
<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 n(U)
<br /> Number of Stories Overlay/Agreement m Q
<br /> Basement ❑No ❑Yes, Fin I 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 ❑No
<br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$
<br /> Fire Alarm: El Update Existing ❑New System ❑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'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes:
<br /> VALUATION CALCULATION: Total$ / 0SO.Do
<br /> 1 NI 14 -7/7,J/27
<br /> Approved By: Date:
<br /> PUBLIC WORKS'
<br /> IntakeOK by: Date,',.,,,,,,,,,,,,,,,..,,,.,.,,,.,..,...,,,.,,,.,,,.,,,,,,..,,...,,,,,,,..,...., ,
<br /> Additional Notes: Intake Comments: IPW Worksheet Needed if:
<br /> `DSys Dev Eval ❑Traffic Mit Eval
<br /> / !Mite Work or Drainage Proposed
<br /> Approved B Date:O7/Z7 /74fZ� l]Backflow Prevention for high hazard:
<br /> 7 i(dental,medical,animals,mortuary,hospital,
<br /> tsupportive 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred
<br /> 0 This Permit is A roved byPublic Works •
<br /> Additional Notes: �� Pp
<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 ❑ Is located in this folder
<br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder coin 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 By: Date:
<br /> 4......--
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