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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �Z2����'✓� <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑Route to Commercial Building Attach to Project No. P1.7,Z071 <br /> ❑ Route to Residential Building Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ❑ OK to Route to Other Departments <br /> BldglTl/Addn/Rem Size 16 Co&pa - � ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone v <br /> Number of Stories Overlay/Agreement <br /> Basement )71No ❑Yes, Fin/Unfin Nonresidential Use 1l <br /> Type of Construction —a Residential Use <br /> Occupancy Group (4 Proposed No.of Dwelling Units: <br /> Occupancy Load ( -95 Total No.of Dwelling Units: <br /> Fire Sprinklers:IZIUpdate Existing❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? Oyes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: 2g 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? Oyes 1g No DI Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 does required prior to final? ❑Yes lNo Additional Notes: j <br /> � <br /> VALUATION CALCULATION: Total$a, JOP)0oQ 9 ,ee <br /> �' <br /> Approved By: Date: c(, )5,ZZ, <br /> BLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: =PW Worksheet Needed if: <br /> Z ..�'� ., I�13�3 DSys Dev Eval ❑Traffic Mit Eval <br /> I DSite Work or Drainage Proposed <br /> t/ Backflow Prevention for high hazard: <br /> Approved By: Date: 9(4 C/ . GZ/et. - •06-2..� <br /> 7 <br /> o�(dental,medical,animals,mortuary,hospital, <br /> Q� i S � ;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 /> ❑See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: • 0 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 0 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: Public Works has no scope---PW Not Required <br /> dditional Notes: <br /> ELECTRICAL (��,,, y� <br /> �6 (jol�?Iit)Additional Notes: C� W` l aUU'J►1►I�—cat -tG)Approved By: Date: Approved By: Date: 1 <br />