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Intake &Approval Sheet (FOR PERMIT STAFF ONO) PERMIT# ����—( _ <br /> BUILDING PLANNING- <br /> Intake OK by: 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 /> BldgfTI/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 Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: []Update Exsting El 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 priorto final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> !Approved By: Date: <br /> PUBLIC WbRKS' <br /> Intake OK by: Date: <br /> _..........._....,.__._ __. .. ,,_ .,... _..__._.._...,.._.._.._...._ <br /> Additional Notes: Intake Comments: PW Worksheet Needed if, <br /> []Sys Dev Eval I]Traffic'Mit Eval <br /> El Site Work or Drainage Proposed. <br /> Approved By: Date: ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> (supportive housing) <br /> FIRE DEPARTMENT ❑Route this folderfor 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: .; his Permit is Approved by Public Works w <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 Qoln% lth this folder for permit issuance) <br /> view/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 Not ,/ ��,!h rw P ip v` j Z <br /> ELECTRICAL (� <br /> Additional Notes: <br /> Approved By: Date: Approved By: _�T Date: <br />