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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#1 1 kg -o SZ <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewe <br /> ❑ 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 r S <br /> Number of Stories Overlay/Agreement <br /> Basement El 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 ONew System ❑Not Req'd Planning/Landscape Inspection Req red before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ONew 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 0 No DEverett School Dist ❑Mukilteo School Dist. <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: LA <br /> �� " \.. i\PCRN"`Q''"\-k• LktAA N <br /> VALUATION CALCULATION: Total$ c< 4\14() UA Pka \ot. 0\ 4 V <br /> SWC <br /> Approved B -- Date: 1t(i l)V- <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet eded if: <br /> ❑Sys Dev al ❑Traffic Mit Eval <br /> ❑Site ;•rk or Drainage Proposed <br /> VDB- flow Prevention for high hazard: <br /> Approved By: . Date: �� (d= tal,medical,animals,mortuary,hospital, <br /> Ipportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Revi- at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a sep:rate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Fol.-r ❑Submitted Previously ❑Deferred <br /> OSending Fire Notes to Project Team 0 This Permit is Appr.'ed by Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review orksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ONew System 0 Not Req'd 0 A Separate P H/ Permit is Required(Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ONew System 0 Not Req'd AND 0 Is lo ated in this folder <br /> Chemical Sup: ❑Update Existing ONew System 0 Not Req'd 0 I in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ■ ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Pu-, is Works has no scope---PW Not Required <br /> Addi 'onal Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />