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Intake &Approval Sheet FOR PERMIT STAFF ONLY PERMIT# \ t \'\' 6'24 <br /> BUILDING PLANNING <br /> Intake OK byL A1A I)• 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.-'‘Qk <br /> Number of Stories Overlay/Agreement `• A. \. <br /> Basement ONo ❑Yes , Fin/Unfin Nonresidential Use `n.Qf,\� rl 'r�;�`\esS c\a3 <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? ❑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 ❑Everett School Dist ❑Mukilteo School Dist \ <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additi nal Notes: 9,�p 'ose( U �\ � `QGOI,r\Id tOA Jr <br /> VALUATION CALCULATION: Total$ ,rO(t WV\ vkv.s\ \DQ tue0.40.41 \Gy 'ef-m\l'A,A <br /> Approved By: ..54-- Date: \.C:).T. MC <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> Mite Work or Drainage Proposed <br /> Approved By: Date: ‘ j//'ivi ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT ❑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 /> ❑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: DUpdate Existing ❑New System ❑ NOt Req'd ❑A Separate PW Permit is Required(Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ONew System ❑ Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System ❑ Not Req'd ❑ 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 /> Approved By: Date: 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> �hi <br />