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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# HSbq'CI D <br /> BUILDING PLANNING <br /> Intake OK by: Ai., Date: 11 101127 Intake OK by AJ Date: eV/0 ii5e <br /> Intake Comments, Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ,❑ RR ate to Historic Reviewer <br /> ❑ Make this a"W"Permit Lb OK to Route to Other Departments <br /> Bld I)wdn/Rem Size , .)J-02,7"--rt. ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone C 'Q_ <br /> Number of Stories / Overlay/Agreement <br /> Basement EgNo ❑Yes, Fin/Unfin Nonresidential Use SI(10 'c b2A ie <br /> Type of Construction V`'ff Residential Use r——J <br /> Occupancy Group Proposed No. of Dwelling Units: 4.----- <br /> Occupancy Load *7/ Total No. of Dwelling Units: <br /> Fire Sprinklers: Update Existing ❑New 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 ❑New System ❑Not Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: zc Zilf)70/5. 1 '` 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 ❑No Additional Notes: .......------ <br /> VALUATION CALCULATION: Total$ 5-9 O <br /> ApprovedPV{ ' ' Date: q/f ED /i ' <br /> PUBLIC WORKS <br /> Intake OK by: —T-72-0 Date: 9 Ito II% <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> Ha-' .—3 D(lb---d e...,2) 04, Mo a."4.0.4.a wort-K. ❑Sys Dev Eval ❑Traffic Mit Eval <br /> 02.L'G'--., "o emaahE ot: <br />