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PERMIT STAFF ONLY) 220✓-656 <br /> ApprovalIntake & Sheet (FOR PERMIT# <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 a uo 4.4)- ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone ln.� <br /> Number of Stories .. Overlay/Agreement <br /> Basement EINo ❑Yes, Fin/Unfin Nonresidential Use C \1C— <br /> Type of Construction IL- Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load La Total No.of Dwelling Units: <br /> Fire Sprinklers: Ell Update Existing New System Mot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: 51LliDdate Existing El 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? ❑Y rr✓✓11 <br /> es Io.r No El Everett School Dist ❑Mukilteo ool Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes Ea No Additional Notes: <br /> VALUATION CALCULATION: Total$ 23o�(pt� <br /> Approved,® - --� Date: 22. 20t� <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: 7145(20?.2., ❑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 217Fire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: This Permit is Approved by Public Works <br /> r`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: ., (,,)keN Date: 3;29.„40 ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved ate: 41-7IZ4)22 <br />