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• 6+� <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# I21° ap <br /> --01 <br /> BUILDING PLANNING Intake OK by: Date: Intake OK by:a Assign To: O Z, Date:f /11/202 J <br /> Intake Comments: Intake Comments: <br /> • <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Ro to 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 .�n <br /> Basement El No Ekes, Fin/Unfin Nonresidential Use Wirv�as t-ACMIO <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 ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? Oyes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <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? ❑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$ 7/coo <br /> Approved By: t✓"Y Date: gill /zz-t <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: �j{-1z7c,-tip( tu,�et4- on& Intake Comments: _PWWorksheetNeeded if: <br /> 1'1 `���d ee �f {Z�1a a LE-Ver4 _OSys Dev Eval ❑Traffic Mit Eval <br /> 5 n.Puci perpohs1 b44. ,r cies4 . _DSite Work or Drainage Proposed <br /> Approved By: Date: Sl(2-f¢�yt =DBackflow Prevention for high hazard: <br /> ) I _(dental,medical,animals,mortuary,hospital, <br /> :supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheetmw~--- <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: ❑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#: <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(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: Ifrrublic Works has no scope---PW Not Required <br /> Additional Notes: ( <br /> ELECTRICAL L� �� <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />