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Intake &Approval Sheet (FOR PERMIT STAFF ONLY). PERMIT# �l L'� Val <br /> BUILDING PLANNING <br /> Intake OK by: Date: lZ/SA/ Intake OK by Assign To:Q{OQQ.1.f//� <br /> Date: \tOG. l: <br /> Intake Comments: Intake Comments: <br /> _"•_eN\ CND N'eaC k t ti�t�QC Ec\c1,3�,n5©,A.t.k, <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 ❑ Hold in Planning File Drawer <br /> Garageecessor Struct.Size 908. _ Zone —\ <br /> Number of Stories Overlay/Agreement <br /> Basement EtNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group K. Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <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 ONew 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? ❑Yeslo ❑Everett School D' ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: <br /> VALUATION CALCULATION: Total $ (Dt 20C9 <br /> Approved By: Date: 2 dsj sp'Ld <br /> PUBLIC WORKS <br /> Intake OK by:r P Date: 12 I OS 12b 19 <br /> Additional Notes: 2 Of inc.. Intake Comments: PW Worksheet Needed if: <br /> e-A i OSys Dev Eval ❑Traffic Mit Eval <br /> b° DSite Work or Drainage Proposed <br /> Approved By: Date: /2.3/Z0 '❑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 I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> CI Fire Sprinklers El 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: 0 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 ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 'Public Works has no scope PW Not equired <br /> Additional Noe /2/oS/2otq <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> � Iv <br />