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Intake&Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT 14?(9,C)1 -003 <br /> -:.. --to:::',:'--. ;-;:vittilototitort-P-, -441):a4 *itati.,:,:;,,,,,;, .-fr.:173 Sia!!,'1'7,::01,001: 71.111-if T-4'',4;i14-,711 <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 /> O 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 <br /> Number of Stories Overlay/Agreement <br /> Basement ONo DYes, 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 ONew System ONot Req'd Planning/Landscape Inspection Required before Final? DYes ONo <br /> Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ <br /> Fire Alarm: DUpdate Existing ONew System ONot Req'd School Impact Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? DYes 0 No DEverett School Dist OMukilteo School Dist <br /> Add.'RCW 64.55 docs required prior to final? °Yes DNo Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: I PW Worksheet Needed If. <br /> DSys Dev Eval OTraffic Mit Eval <br /> Le <br /> �, !Mite Work or Drainage Proposed <br /> Approved By: S kQ_1? A Date: VI lo-) 1 141 IOBackflow Prevention for high hazard: <br /> i(dental,medical,animals,mortuary,hospital, <br /> ;supportive housing) <br /> ,Itvit , a,R' IENT �` ..fitRoute this folder for PW Review at end --- PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) OThis 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 ONew System 0 Not Req'd 0 A Separate PW Permit is Required(Permit#: PW ) <br /> Fire Alarm: DUpdate Existing ONew System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: DUpdate Existing ONew System 0 Not Req'd 0.Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: El 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 /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> Z <br />