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Intake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#E 1 $LO <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> 0 Route to Commercial Building 0 Attach to Project No. <br /> 0 Route to Residential Building 0 Route to Historic Reviewer <br /> D Make this a"W' Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ONo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? DYes ONo <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: ❑Update Existing ONew System DNot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes 0 No ❑Everett School Dist DMukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? DYes ONo Additional Notes: <br /> VALUATION CALCULATION: Total $ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by:_ Date: <br /> Additional Notes: Intake Comments: iPWWorksheet Needed If: <br /> ©Sys Dev Eval ❑Traffic Mit Eval <br /> Mite Work or Drainage Proposed <br /> =DBackflow Prevention for high hazard: <br /> Approved By: Date: (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at end --- PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) °This project also has a separate concurrent PW Review (Green Folder) <br /> ❑Route to Fire Drawer--- Fire Preliminary Review Notice AND °Create Green Folder °Submitted Previously °Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items <br /> Fire Sprinklers: °Update Existing °New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW <br /> Fire Alarm: °Update Existing ©New System O Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: DUpdate Existing ONew System 0 Not Req'd D Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: El Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: ! Y Date: / / /j Approved By: Date: <br /> � v <br />