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Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT#� —2o-'� 'O L h <br /> BUILDING PLANNING <br /> ���� <br /> Intake OK by: Date: Intake OK by: Assign To4r, Date: rZ Zd <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 40K to Route to Other Departments <br /> Bldg/TI/Addt�/ ern Size 1 Z 6a V l/,F;e4Z 2 ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size .A./O Zone <br /> Number of Stories %' Overlay/Agreement <br /> Basement IDNo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction rr i3 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 Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑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? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? []Yes ONO Additional Notes: <br /> VALUATION CALCULATION: Total$ CO Oo0 UC <br /> Approved By: Date: '7 ;Z- 2�12_2 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: PW Worksht Needed <br /> Intake Comments: ee if. <br /> []Sys Dev Eval ❑Traffic Mit Eval <br /> C I El Site Work or Drainage Proposed <br /> Approved By' Date'O 7 �ZO7Z ;❑Backflow Prevention for high hazard: <br /> 1(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Workshee t <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 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(join with this folder for permit issuance) <br /> El Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: — .2 ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 72-- <br />