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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# <br /> BUILDING PLANNING' <br /> Intake OK by: Date: Intake OK by: Assign To; Date: <br /> Intake Comments: Intake Comments: <br /> a <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ cute to Historic Reviewer <br /> ❑ Make this a"W"Permit K 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 <br /> Basement ❑No ❑Yes, Fin 1 Unfin Nonresidential Use . <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Loa Total No.of Dwelling Units: <br /> Fire Sprinkle/ []Update Existing ❑New System []Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes []No <br /> Reason S inklers Required: "In Lieu" Fee:Type: Amount <br /> Fire AI El Update Existing El Now System El Not Req'd School Impact Fee: Total $ <br /> Rea Fire Alarm Required: Calculated: Credit: <br /> R 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukllteo School Dist <br /> dd'l RCW 64.55 docs required prior to final? ❑Yes []No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: Q L <br /> PUBLIC WbkKs-� <br /> Intake OK by: Date: <br /> Additional Notes: f Intake Comments: WIN Worksheet Needed If., W_ <br /> (9N�y sE]Sys Dev Eval QTraffic Mit Eval <br /> :[]Site Work or Drainage Proposed <br /> Approved By; Date: 0 �E]Backflow Prevention for high hazard: <br /> ?(dental,medioal,animals,mortuary,hospital, <br /> €supportive housing)LMY 'N,._.,^`LL <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 /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND El Create Green Folder []Submitted Previously ❑Deferred <br /> Additional Notes: ❑This Permit is Approved by Puhlic 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-guilt 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 aoln with this folder forparmit 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 /> Approved By: Date: Appraved By: Crate: <br />