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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:I A Assign To: Date; <br /> Intake Comments: Intake Comments: <br /> e <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit DK to Route to Other Departments <br /> BldgCfl/Addn/Rem Size 9(Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone V <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . <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 Update EAsting New System Not Req'd PlanninglLandscape Inspection Required before Final? ❑Yes ONO <br /> Reason Spr klers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alar ; ❑Update Exisiing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reaso Fire Alarm Required: Calculated: Credit: <br /> RC 64,55 MF worksheot req'd for permit? ❑Yes ❑ No ❑Evereft School Dist ❑Mukilteo School Dist <br /> d'I ROW 64,55 docs required prior to final? ❑Yes �J❑No Additional Notes: <br /> VALUATION CALCULATION: Total$` <br /> Approved By: Date: �i ZOZz <br /> PUBLIC WORKS-* <br /> Intake OK by: Date: <br /> Additional Notes: <br /> Intake Comments: {PW Worksheet Neededif <br /> t <br /> .� (❑Sys Dev Eval ❑Traffic'Mit Eval <br /> Site Work or Drainage Proposed <br /> pate: DBackf low Prevention for high hazard: <br /> Approved By <br /> !(dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> r.-.-_...—.�.__..-.__--�_..�-.,-,_._.,.__--..-__........__— <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Subinittals 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 /> ® 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 Qoln with this folderfor 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 /> f <br /> Approved By: Date: Approved By: Date: <br /> f <br /> f <br />