Laserfiche WebLink
f?. <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S <br /> BUILDING PLANNING <br /> Intake OK by:_ Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> Sw0W€\\ C \\C�. <br /> \IsA Evece \Vs�C;c.c Q�>z�c�ke <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 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size '70 5K 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone u \c <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use rrJJ <br /> Type of Construction T/`d3 Residential Use Sc`( <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: Q <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amo <br /> Fire Alarm: ❑Update Existing El New System Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: redit: <br /> RCW 64.55 MF worksheet req'd for permit? El Yes gjil No ❑Everett School Dist ukilteo School Dist <br /> Add]RCW 64.55 docs required prior to final? ❑Yes 12No Additional Notes: <br /> VALUATION CALCULATION: Total $ <br /> S( Or9.o% <br /> Approved By: � Date: (p. CA. A'L i <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes:Z.0/rf"' //QC-- t" 4/SeC Intake Comments: 1PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: 12//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 /> OFire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 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 ❑ Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope---PW Not Re uired <br /> Additional Note�:�� ®./''�✓ -rs7(. f 2r <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 7/ <br />