Laserfiche WebLink
1 ywoons -___ <br /> 4 �-Intake &Approval Sheet r ®R PERMIT STAFF ONLY) PERMIT# e vo Lc-6 -623 <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 Reviewer <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 C- <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use 4bLe.4 <br /> Type of Construction Residential Use <br /> / . <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 "lo <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 ❑Everett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? Oyes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ _ O 5 fe�� kik <br /> A `� \o. lq )g.!J <br /> Approved By: ,,inci Date: 10.--L4-(( <br /> PUBLIC WORKS / <br /> Intake OK by: I Y�'., Date: M I1 I�(cl5 <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> 'm\- nel rpt A uo [ , ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ialJ ret , v [�(�i ❑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 pt1 Route 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 /> DRoute to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> ❑Sending Fire Notes to Project Team Jk 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 0 Not Req'd AND Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: /'� ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> C Approved By: 4- '/5 Date: (p`i3/,' 0 Public Works has no scope--- PW Not Required <br /> / Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: - <br /> Approved By: Date: Approved By: 15ate: /Q% bzoys <br /> 1/ <br />