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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# MkZ0cA —050 <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 W <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , 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: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes RiNo <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: Calculated: -•I : <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? ❑Yes ENo Additional Notes: iZ' 'iS 3p <br /> VALUATION CALCULATION: Total$ <br /> ` rIL <br /> Cc }� eti5bnm� '1 <br /> Approved By: ,�c. J Date: q <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed i <br /> ❑Sys Dev Eval 0 affic Mit Eval <br /> ❑Site Work or Dr. age Proposed <br /> Approved By� O�,.,i9 Date: .04/44/Z0/45 ❑Backflow Pr ,,ention for high hazard: <br /> (dental,medic ,animals,mortuary,hospital, <br /> supportive e.using) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at en• - PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate co, urrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder 0 bmitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approved by 'ublic Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Works -et and associated attached items <br /> Fire Sprinklers: ❑Update Existing [hew System 0 Not Req'd 0 A Separate PW Per is Required (Permit#: PW <br /> Fire Alarm: ❑Update Existing [hew System 0 Not Req'd AND 0 Is located it this folder <br /> Chemical Sup: ❑Update Existing 0 New System 0 Not Req'd 0 Is in a S;•arate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ❑ Will bz. ssued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public Wo s has no scope--- PW Not Required <br /> Additional N'-ass: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> tl <br /> 1) <br /> 77i <br />