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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# �)22CO --�'� <br /> BUILDING PLANNING <br /> Intake OK by: 04 Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <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 /> Bldg/TI/Add Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone t <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No IRYeS Fi 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 lot Req'd Planning/Landscape Inspection Required before Final? []Yes o <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System—ONot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes allo El Everett School Dist ❑Mukilteo School 6st <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: rw <br /> VALUATION CALCULATION: Total $ SO Co / UZ(Y_-mil CQj j;Px,>Q,�. C<� /lk <br /> Approved By: Date: <br /> UBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: nT,� Intake Comments: I PW Worksheet Needed If: <br /> �o)G A LTERX11 0k)� SJ��"/ ❑Sys Dev Eval []Traffic Mit Eval <br /> cf t!_'A ❑Site Work or Drainage Proposed <br /> Approved By: Date: Zt Z7--- ❑Backflow Prevention for high hazard: <br /> i(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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El 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 /> ❑ 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 Coin 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 /> Additional Notes: <br /> ELECTRICAL/PLUMBING <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> �y. <br />