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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 /> 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 OK to Route to Other Departments <br /> Bidg[FI/Addn/Rom Size 9Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <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 Existing ❑New System ❑Not Req'd PlanninglLandscape inspection Required before Final? ❑Yes ❑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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'[RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: <br /> PUBLIC W RKS <br /> Intake OK by: Date <br /> Additional Notes: r,ia t;�,.,; �s Intake Comments: PW Worksheet Needed if., <br /> IE]Sys Dev Eval ❑Traffic MIt Eval <br /> l]Site Work or Drainage Proposed- <br /> I]Backflow Prevention for high hazard: <br /> Approved By: Date � y �� »tL�. ((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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND El create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑This Permit is Approved by Public,Works <br /> Additional Notes: � <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Pees: ❑ A Separate PW Permit is Required (Permit#: PW } <br /> E ❑ 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 Wth this folderfor permit issuance) <br /> ❑ Will be issued separately(Separate Green Folder,PW Issued ahead of Bldg) <br /> El Review/Inspection Scope-ADD FIRE FEE <br /> Approved By: Date: El Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> i <br />