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• <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# CPD <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building 0 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 /> ``II <br /> Number of Stories Overlay/Agreement Akt It \\N5 \r <br /> Basement ON. ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use �\--(K <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update -fisting ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes NENo <br /> Reason Sprinklers Req ed: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑U.:ate Existing El New System El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alar Required: Calculated: Credit: <br /> RCW 64.55 MF -orksheet req'd for permit? ❑Yes ❑ No El Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 6'.55 docs required prior to final? /❑--Yes ❑No Additional Notes: <br /> VALUAT •N CALCULATION: Total$ (vL7Z, 77( <br /> Approved By 77— Date: \2- ,2d� <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 /> j ❑Site Work or Drainage Proposed <br /> Approved By: L .� Date: /�"�/; / _❑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 ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> 0 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 Goin 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: Date: ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />