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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # 6R6 ' Z J <br />BUILDING <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route to Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/Addn/Rem Size <br />Garage/Accessory Struct. Size <br />Number of Stories <br />Basement <br />❑No ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load: <br />Fire Sprinklers: ❑Update Existing El New System <br />❑Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing El New System <br />❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes <br />❑ No <br />Add'I RCW 64.55 docs required prior to final? ❑Yes <br />El No <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />Approved By:. Date: <br />FIREDEPARTMENT <br />Intake: (Needed for Townhomes, Alley load SFR, New Commercial) <br />❑Route to Fire Drawer --- Fire Preliminary Review Notice <br />❑Sending Fire Notes to Project Team . <br />Date: (OK to Route to Other Departments) <br />Fire Sprinklers: ❑Update Existing ElNew System _[21Not Req'd <br />Fire Alarm: EKpdate Existing New System ❑ NotReq'd <br />Chemical Sup: El Update Existing El New System Not Req'd <br />Additional Notes: <br />Approved By: <br />Date:LO <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by: Date: <br />Intake Comments: Assign To: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />❑ OK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection. Required before Final? ❑Yes ❑No <br />"In Lieu" Fee: Type: Amount $ <br />School Impact Fee: Total $ <br />Calculated: Credit: <br />❑Everett School Dist ❑Mukilteo School Dist. <br />Additional Notes: <br />!Approved By: Date: <br />PUBLIC WORKS <br />Intake OK by: Date: <br />Intake Comments: ;PWWorksheet Needed if, <br />• <br />❑Sys Dev Eva[ ❑Traffic Mit Eva[ <br />(]Site Work or Drainage Proposed <br />1]Backflow Prevention for high hazard: <br />(dental, medical, animals, mortuary, hospital, <br />;supportive housing) <br />❑Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />❑ This Permit is Approved by Public Works <br />❑ See PW Review Worksheet and associated attached items <br />❑ A Separate PW Permit is Required (Permit #: PW ) <br />AND ❑ Is located in this folder <br />❑ Is in a Separate Green Folder (join with this folder for permit issuance) <br />❑ WIII be issued separately (Separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: Date: <br />Z/� <br />