Laserfiche WebLink
Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# CW NO \—00) <br /> BUILDING PLANNING <br /> Intake OK by: Dater 177 r( Intake OK by Date: ,' <br /> Intake Comments: Intake Comments: Assign To: I oar <br /> ❑ Route to Commercial Building ®Attach to Project No. k)(1\Cg/ -cYS <br /> ❑ Route to Residential Building ❑ RR ute to Historic Reviewer <br /> k(lake this a"W" Permit MK to Route to Other Departments <br /> Bldg/TI/Add er' ize g10 5"I 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size .0"- Zone .. <br /> Number of Stories 1 Overlay/Agreement <br /> Basement JNo DYes , Fin/Unfin Nonresidential Use <br /> Type of Construction `F Residential Use S.. <br /> Occupancy Group f2 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 Fin- ,Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: ` • nt$ <br /> Fire Alarm: ❑Update Existing ❑New 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? ❑Yes Er No DEverett School Di DMukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes r2iNo Additional No - : <br /> VALUATION CALCULATION: Total$ 3/( Z'rO <br /> Approved 13!<L "------ Date: 2 Q-A• '1\. <br /> PUBLIC WORKS <br /> Intake OK by:---rINA Date: I I-1 1 20 (9 <br /> Additional Notes: Z ©/6 /AC # iIS)S ieC Intake Comments: PW Worksheet Needed if: <br /> •• I h►t-'r:ms's 2- €'"'"O I— ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ' w^1 %ws 12'°°F""4 411' ❑Site Work or Drainage Proposed <br /> Approved By: ail Date: Ib`3i/( .r4 o MEA14 %4A' svaF, ❑Backflow Prevention for high hazard: <br /> µo 3't5'c,E.•t 'oE�+ FSS (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> Pe -r1E.sc. .aa-rES -ro•6tvdr--Qtcvw,rrc <br /> FIRE DEPARTMENT ` oute this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) DThis 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 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing Chew System 0 Not Req'd 0 Is in a Separate Green Folder coin with this folder for permit issuance) <br /> Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: Public Works has no scope PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: SircA,SirDate: 1 i 96 UY"4 <br />