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• <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# 6 2-'1 O X ^CC)$ <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> • <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 0 OK to Route to Other Departments <br /> Bid 0ddn/Rem Size f f70 ieK 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories I Overlay/Agreement <br /> Basement ,INo ❑Yes, Fin/Unfin Nonresidential Use € iAA\ 126 4 7.nvt.sli__(y�a,� <br /> Type of Construction Residential Use T <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: 96 <br /> Fire Sprinklers: ❑Update Existing ❑New System ri5Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes o <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System INot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes tg No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes ,®No Additional Notes: \�,\ LOON— en <br /> VALUATION CALCULATION: Total$/,3O'e 66 1 <br /> Approved By: V., - 4 Date: %,(0. <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: - -� . <br /> _OSys Dev Eval ❑Traffic Mit Eval <br /> �y��"�,,�Z =❑Site Work or Drainage Proposed <br /> Approved B Date:®//c- "� DBackflow Prevention for high hazard: <br /> • t(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 0 Is in a Separate Green Folder(loin with this folder for permit issuance) <br /> ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Review/Ins Inspection Scope-ADD FIRE FEE p y( pI g) <br /> p p <br /> Approved By: 2?a-c G/rpate: 8-9 z U4 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> .4Additional Notes: <br /> 4'Y —lap fyy t_ "1)01I ztjl ( <br /> Approved By: Date: Approved By: Date: <br /> 2 <br />