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Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT # a �q nIO <br />BUILDING <br />Intake OK by: C Date: (b Z <br />Intake Comments: <br />❑ Route to Commercial Building <br />J Route to Residential Building <br />❑ Make this a "W" Permit <br />g I/Addn/Rem Size <br />Garage/Accessory Struct. Size <br />G. <br />Number of Stories <br />2— <br />Basement <br />' No []Yes, Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />l.( <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: El Update Existing El New System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes RI No <br />Addl RCW 64.55 docs required prior to final? []YesNo <br />VALUATION CALCULATION: Total $ <br />Additional Notes: �� I_� �/`L 2f (hfsaG <br />Approved By: Date: 2-Alkl91 <br />FIRE DEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑ Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: ❑Update Existing El New System ❑ Not Req'd <br />Fire Alarm: El Update Existing El New System ❑ Not Req'd <br />Chemical Sup: ❑Update Existing El New System ❑ Not Req'd <br />Additional Notes: to <br />Approved By: W Date,24 <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK Date:�C� Z <br />Intake Comments: Assign To: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />Er,OK to Route to Other Departments <br />Hold in Planning File Drawer <br />Zone <br />—Z <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Cj <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? ❑Yes MNo <br />"in Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist <br />Additional Notes: <br />Approved By Date: <br />PUBLIC WORKS <br />Intake OK by: Date: I0124-120 f �b <br />- ---- --------------- <br />Intake Comments: ;PW Worksheet Needed if.* <br />NEW SF R- Ad a`' 1A ; ❑Sys Dev Eval ❑Traffic Mit Eval <br />U EewO C.o $G pL, El Site Work or Drainage Proposed <br />'' w -P1Lg - -C ❑Backflow Prevention for high hazard: <br />�' ,JEr l p(t►v cwa� ;(dental, medical, animals, mortuary, hospital, <br />i2?d SF, ;supportive housing) <br />----- - - ----- <br />ffRoute this folder for PW Review at end ----PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder []Submitted Previously ❑Deferred <br />pq This Permit is Approved by Public Works <br />RSee PW Review Worksheet and associated attached items <br />0,A Separate PW Permit is Required (Permit #: PW o34) <br />AND Mfg located in this folder <br />❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) <br />❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved y Date: 4 l J 6; L p l `1 <br />2-1 <br />