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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 /> r <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 /> BidgfTI/Addn/Rem Size Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size zone C <br /> Number of Stories Over]aylAg reement <br /> Basement ❑No es, 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: ❑U ate Existing ❑New System ❑Not Req'd P[anning/Landscape Inspection Required before Final? []Yes ❑No <br /> Reason Sprinkl Required: "in Lieu"Fee:Type: Amount$ <br /> Fire Alarm: []Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reaso ire Alarm Required: Calculated: Credit: <br /> RC 64.55 MF workshoet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukliteo School Dist <br /> dd'I RCW 64.55 docs required prior to final? []Yes El No Additional Notes: <br /> VALUATION CALCULATION: Total$ 7 _ <br /> Approved By: Date: ?i <br /> PUBLIC 1NORKS:" <br /> Intake OK by: _Date:M <br /> Intake Comments: PW Worksheet Needed if.• <br /> Additional Notes: <br /> GL y EQSys Dev Eval QTraffic'Mit Evat <br /> 0Site Work or Drainage Proposed, <br /> d ❑Backflow Prevention for high hazard: <br /> Approved By: ate: C� ' *(dental,medical,animals,mortuary,hospital, <br /> isupportive 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 El Other AND ❑Create Green Folder [ Submitted Previously ❑Qeferred <br /> ❑This Permit is Approved by Public Works <br /> Additional Notes: <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{Join with this folder for 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: ElPublic Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: pate: Approved By: Date: <br />