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Intake & Approval Sheet 9[OR PERMIT STAFF ONLY) PERMIT# S7-7011— �o3 BUILDING �� I IIIIJIIL4NNING • . . . Intake OK by: 1 Date: (8/(1//?022, Intake OK by: Assign To: Date: Intake Comments: Intake Comments: e ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI dd /Rem Size t14 R f ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Y`',,, Number of Stories 2 Overlay/Agreement _ Basement ,1No ❑Yes, Fin/Unfin Nonresidential Use , Type of Construction S Residential Use GJf . Occupancy Group I Proposed No.of Dwelling Units: . Occupancy Load Total No.of Dwelling Units: \ Fire Sprinklers: DUpdate Existing ONew System RNot Req'd Planning/Landscape Inspection Required before Final? [hies 156,o Reason Sprinklers Required: "In Lieu"Fee:Type: - A iTOTITtt _ Fire Alarm: El Update Existing ONew System 6�Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: 0/A- RCW 64.55 MF worksheet req'd for permit? ❑Yes allo DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes RNo Additional Notes: 1.jo, wit- Veie,5 }Q-. VALUATION CALCULATION: Total$ /Z$,06 0 y() cN n r 'e y- OA i-I,l7 23 Approved By: I-. .I( Date: LI. ri. 2"3 BLIC WORKS' Intake OK by: Date: Additional Notes: Intake Comments: {PW Worksheet Needed if: (DSys Dev Eval DTraffic'Mit Eval A f: C Q)J g1I/l3 IDSite Work or Drainage Proposed Approved By: /2,jL Date: WryZU22 luBackflow Prevention for high hazard: '(dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: OThis project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ; . This Permit is Approved by Public Works . 3 • Ail See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑ A Separate PW Permit is Required(Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope--PW Not Required Additional Notes: ELECTRICAL Additional Notes: At.vrSespIAYU re.-rck.rie - e4i00 p3` Zq1Zj Approved By: Date: Approved By A", Date: 0 e� it z �-- "�,, o