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2-0 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# l b\ 0 <br /> BUILDING PLANNING <br /> Intake OK b Date: /LfL//Ztsi„� 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 /> 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 LNo ❑Yes Fin/Unfin Nonresidential Use <br /> Type of Construction j( -- Residential Use <br /> Occupancy Group - 1S Proposed No. of Dwel ng Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Lands tape Inspection Required before Final? ❑Yes ONo <br /> Reason Sprinklers Required: "In Lieu"Fee:T pe: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impa Fee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes I No ❑Everett+chool Dist ❑Mukilteo School Dist <br /> Add'i RCW 64.55 docs required prior to final? ❑Yes ONo Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved B, Date: 12, Z01,7' <br /> PUBLIC WORKS <br /> Intake OK by:-1-1-1 Date: I J /b /2o 19 <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: 4;t ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute 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: ❑Update Existing ❑New System 2 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW <br /> Fire Alarm: ❑Update Existing ❑New System '15] <br /> Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: )u0 /L4-,l4ri) i ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:s Date: /- / s- /°f hA ublic Works has no scope PW Not Required _ <br /> Additional Note • <br /> ELECTRICAL 7,4 /Zoe <br /> Additional Notes:. <br /> Approved By: Date: Approved By: Date: <br /> 7_11 <br />