Laserfiche WebLink
• <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 2 O cob <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 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ..ttai0 4,t2- 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories 3. Overlay/Agreement <br /> Basement EllNo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction V'6 Residential Use <br /> Occupancy Group J'- Proposed No.of Dwelling Units: <br /> Occupancy Load a- Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System EiNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: 4 (A°op--t-4- "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ONew System 131Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: < oOz7--C-1-2 Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes El No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes (INo Additional Notes: <br /> VALUATION CALCULATION: Total$_ 4 3,©C'e' 11 �� I • t <br /> . Sal ( i o1 <br /> Approved By: ,, tzte Date: rJ. (.0�" <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: 4°"E.KIE9, to m,L.a-nca Intake Comments: i PW Worksheet Needed if: <br /> I❑Sys Dev Eval ❑Traffic Mit Eval <br /> i❑Site Work or Drainage Proposed <br /> Approved By: Date: .(E'f�o i❑Backflow Prevention for high hazard: <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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 This Permit is Approved by Public Works ` <br /> 0 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 0 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 /> N./Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Ue, Date:5C(g fira ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: 15-1 <br /> (p 11)131,6 <br />