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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#gi'12,2.O 1612- <br /> BUILDING PLANNING <br /> • <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 0 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 <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 ❑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 dots required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> intake OK by: . Date: <br /> Additional Notes: Intake Comments: PW o <br /> •PW Worksheet Needed if: <br /> tOSys Dev Eval OTraffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> Approved By: Date: OBackflow 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by 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 0 Is located in this folder <br /> ❑Minimal or No Fire Scope-NO FIRE FEE ❑ is in a Separate Green Folder(join with this folderfor permit issuance) <br /> ErReview/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:\,?rQw y ) Date:5:-.241 ' ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 17—— <br />