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-11 <br /> Intake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# IAA,(1.r(' '.61 1 <br /> 4,rt s <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 /> Make this a"W'Permit Q 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: DUpdate Existing New System DNot Req'd Planning/Landscape Inspection Required before Final? DYesNo <br /> Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ <br /> Fire Alarm: OUpdate Existing Chew 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 r0 No Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? DYes DINo Additional Notes: <br /> VALUATION CALCULATION: Total$ 3 T Afv, & ' <br /> Approved Date: ///20//Z <br /> ::,,,,,,,-:-, ,Z, z ,,? WPMH9RKS g >., <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: 1 PW Worksheet Needed/h. <br /> OSys Dev Eval OTraffic Mit Eval <br /> 'Mite Work or Drainage Proposed <br /> Approved„7t Date:/..//zO/a :Backflow Prevention for high hazard: <br /> � :(dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> aditi i` DEPART ENT Route this folder for PW Review at end --- PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) EIThis project also has a separate concurrent PW Review (Green Folder) <br /> .Route to Fire Drawer---Fire Preliminary Review Notice AND EICreate Green Folder 0Submitted Previously EIDeferred <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: DUpdate Existing ONew System 0 Not Req'd 0 A Separate PW Permit is Required(Permit#: PW ) <br /> Fire Alarm: ElUpdate Existing LINew System ❑Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: DUpdate Existing ©New System D Not Req'd 0 Is in a Separate Green Folder (loin with this folder for permit issuance) <br /> Additional Notes: 0 Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: D Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ,:,,:'Y,:,::•Aligilk,,::”M.tt:td,TAidikt,,,,,,;,,.,air: ::::-„ .''1:;, Ai/g____ - . ia<S /i pad' <br /> Additional Notes. <br /> Approved By: Date: Approved By: Date: <br /> ("-\1),...111 <br />