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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#1C( WZ -003 <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 <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 Dwellins Units: <br /> Occupancy Load Total No. of Dwelling J nits: <br /> Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd PlanninglLandsc-•e Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Ty.e: Amount$ <br /> Fire Alarm: ❑Update Existing [hew System ❑Not Req'd School Impac Fee: Total $ <br /> Reason Fire Alarm Required: Calculated. Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Ever= t School Dist ❑Mukilteo School Dist. <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Addif anal Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Neede. if: <br /> ❑Sys Dev Eval . raffic Mit Eval <br /> ❑Site Work or D'-inage Proposed <br /> Approved By: Date: $ �(B ❑Backflow P vention for high hazard: <br /> (dental,medi.-I,animals,mortuary,hospital, <br /> supportive ousing) <br /> FIRE DEPARTMENT DRoute 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 concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---FirePreliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is Approved • Public Works <br /> Date: (OK to Route to Other Departments) 0 See PW Review Wo sheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ONew System 0 Not Req'd 0 A Separate PW 'ermit is Required (Permit#: PW ) <br /> Fire Alarm: ❑Update Existing ONew System 0 Not Req'd AND 0 Is loc. ed in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 I n a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: . ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 Pu. is Works has no scope---PW Not Required <br /> Addi ..nal Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />