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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) + PERMIT#f4 2 8 OQ( <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ID Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit _ _ 0 OK to Route to Other Departments <br /> Bldg/Tl/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/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 Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinkl- s Required: "In Lieu"Fee:Type: Amount$ <br /> � <br /> Fire Alarm: U 'date 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'I RCW 64.55 docs required prior to final? :Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total <br /> Approved By: Date: • <br /> - <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: =PW Worksheet Needed if <br /> ESys Dev Eval OTraffic Mit Eval <br /> iDSite Work or Drainage Proposed <br /> Approved By: Date: =DBackflow 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: ❑This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached.items <br /> Fire Dept.Fees: ❑A Separate PW Permit is Required(Permit#: PW ) <br /> El 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 /> eview/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: A. 14L 12 Date: ey7/2 Z ❑ Public Works has no scope--PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: • Date: <br />