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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) 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 ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement RNo ❑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: El Update Existing El New System []Not Req'd Planning/Landscape Inspection Required_4 ore Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "in Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑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$ S CYta <br /> Approved By Date: W \I-\. ZQ�� <br /> PUBLIC WORKS <br /> 5i11gjoLT To Intake OK by: Date: t t 4 20 9 <br /> Additional Notes: 2v/S /KL S 6JSoEC Intake Comments: ,PWWrksheet Needed if.• <br /> #[JSys Dev Eval El Traffic Mit Eval <br /> IEl Site Work or Drainage Proposed <br /> Approved By: Date: j i-1b Sao` l]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 ❑Fire Alarm []Other: AND El Create Green Folder El 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 M 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 ,,��f, ❑ Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> Approved By: Date: lypublic Works has no scope---PW Not Required <br /> Additional Note LA 1 9 <br /> ELECTRICAL � <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />