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Intake &Approval Sheet FOR PERMIT STAFF ONLY) PERMIT# i Y ` zog'-otig <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/Tl/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone C Z — -5 <br /> Number of Stories Overlay/Agreement _ <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use lif (ern <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: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo Soho Dist. <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: 9,•TO A O — <br /> ot\VALUATION CALCULATION: Total$ roof <br /> Approved By: IL , , Date: e'-lS—)' <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Neede, if: <br /> ❑Sys Dev Eval klTraffic Mit Eval <br /> ❑Site Work o drainage Proposed <br /> Approved By: V Date: e!,// //e7 ❑Backflo •revention for high hazard: <br /> / / (dental, dical,animals,mortuary,hospital, <br /> { suppos a housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at , d ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separat- oncurrent PW Review(Green Folder) <br /> 0 Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder F Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approved,iy Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Wor sheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW P•rmit is Required(Permit#: PW ) <br /> Fire Alarm: ❑Update Existing❑New System 0 Not Req'd AND 0 Is locat-d in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in : Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ❑ W be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Public orks has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />