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Intake&Approval Sheet (FOR PERMIT STAFF ONL)9 PERMIT# Zk g(0 — ,L{
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<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 El Route to Historic Reviewer
<br /> 0 Make this a"W'Permit El OK to Route to Other Departments
<br /> Coro SZZ SF 0 Hold in Planning File Drawer
<br /> Garage/Accessory Struct. Size Zone E'- I {&AAIAt)
<br /> Number of Stories / Overlay/Agreement
<br /> Basement [ No DYes, Fin/Unfin Nonresidential Use
<br /> Type of Construction 1/6 Residential Use
<br /> Occupancy Group 6 Proposed No.of Dwelling Units:
<br /> Occupancy Load 66 Total No.of Dwelling Units:
<br /> Fire Sprinklers: OUpdate Existing ONew System r Not Req'd Planning/Landscape Inspection Required before Final? DYes DNo
<br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$
<br /> Fire Alarm: Update Existing ONew System ONot Req'd School Impact Fee: Total $
<br /> Reason Fire Alarm Required: ex s j✓S-G,1 ,v0 e#0r4 ,Mt Calculated: Credit:
<br /> RCW 64.55 MF worksheet req'd for permit? bYes No 0Everett School Dist DMukilteo School Dist
<br /> Add'I RCW 64.55 docs required prior to final? Dyes raNo Additional Notes: Wt., t i.r��--pc,
<br /> VALUATION CALCULATION: Total$ .�/0 `
<br /> Approved Date: i b(i� f}g'
<br /> fir. t
<br /> Intake OK by: Date:
<br /> Additional Notes:QL( `C' ("24' yvo ce.dsseic',t)r
<br /> ��I/E2r /Jre, Intake Comments: _PWWorkshaetNeededN;
<br /> 3 Pct/°E�ttY g ZZy6 (as/as/qp), *DA*?Galax. V toe *Lys Dev Eval CiTraffic Mit Eval
<br /> ✓MCj4 6-'466 LQ4c4 "/sZ2")C4ar" .ten 1."ZA1 1-Eli°2-"5 CaoeStperiaLtto , . -Site Work or Drainage Proposed
<br /> C64-0 LSsk c-O i Z//g/to/Z.
<br /> Approved By:�,,�„,„ Date: /pAp.8 4>E AS 1 1ST.p14 use, Backflow Prevention for high hazard:
<br /> ;(dental,medical,animals,mortuary,hospital,
<br /> isupportive housing)
<br /> _,4-x<4,,,,,,,-',,:o
<br /> g. ..�;?iz�`�`_ ` R� EDEP , „»� ,' NWf''; Route this folder for PW Review at end --- PW Review Worksheet
<br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) OThis project also has a separate concurrent PW Review (Green Folder)
<br /> °Route to Fire Drawer---Fire PmlminaryReview Notice AND EICreate Green Folder EISubmitted Previously 0Deferred
<br /> QSending Fire Notes to Project Team .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: OUpdate Existing ONew System 0 Not Req'd 0 A Separate PW Permit is Required(Permit#: PW )
<br /> Fire Alarm: OUpdate Existing ONew System 0 Not Req'd AND 0 Is located in this folder
<br /> Chemical Sup: DUpdate Existing ONew System 0 Not Req'd 0 Is in a Separate Green Folder(loin with this folder for permit issuance)
<br /> Additional Not : Will be issued separately (Separate Green Folder,PW issued ahead of Bldg)
<br /> Approved By: J,� , Date: /0/r✓V/ZD4g 0 Public Works has no scope--- PW Not Required
<br /> -0'• C6ov ptr�F-O e,//A' pp g7 ,'f f'HoAvG Additional Notes:
<br /> Additional Notes:
<br /> Approved By: Date: Approved B9' Date:/o,pS/20/8
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