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• • , 1 <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# \\ ._ (.:02_.) <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 i- 0 Route to Historic Reviewer <br /> ElMake this a"W"Permit Tr" ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size S'/' 'Vz'1ft 4 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories H 2A Overlay/Agreement <br /> Basement lit No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction 1/ .1s. Residential Use <br /> Occupancy Group 12.—Z Proposed No.of Dwelling Units: <br /> Occupancy Load 11/ is Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ONew System Mot Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: (Update Existing ❑New 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 t No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add.'RCW 64.55 docs required prior to final? ❑Yes ErNo Additional Notes: <br /> VALUATION CALCULATION: Total $ 46)oC <br /> Approved By: j� Date: (z✓ )'/ <br /> PUBLIC WORKS ff <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =PWWorksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> El Site Work or Drainage Proposed <br /> ppBy: 2—� /a 0� €❑Backflow Prevention for high hazard: <br /> Approved Date: �� g <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 OFire 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 Required <br /> dditional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />