Laserfiche WebLink
Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# <br /> BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: L-0/'4 B. 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" rmit %K to Route to Other Departments <br /> Bldg/TI/Ad Rem Siz 17170 '4 f 11 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size A/v Zone (� 3 <br /> Number of Stories .3 Overlay/Agreement <br /> Basement WNo ❑Yes, Fin/Unfin Nonresidential Use . <br /> Type of Construction Residential Use <br /> Occupancy Group 2 Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing El 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 El Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? W"es ❑ No ❑Everett School Dist ❑Muk[Iteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? I res ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ 't-6° J 00, <br /> )0(fu P/,s' boy n+,6mCfi'49, Approved By: Date: Z ZoZZ <br /> PUBLIC WORKS. <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed If.• <br /> t <br /> IOSys Dev Eval ❑Traffic Mit Eva[ <br /> t <br /> 0Site Work or Drainage Proposed. <br /> Approved Date: <br /> ❑Backflow Prevention for high hazard: <br /> By �6 �,1' 'u'7 <br /> I(dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT El 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 El 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 M PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> Winimal 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: IIPublic Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: 4-2 <br /> Approved By: Date: Approved By: Date: <br /> Z/7 <br />