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Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# dot tbs'0v <br /> UILDING PLANNING <br /> Intake OK by: A"� Date: °� I- Intake OK b : (/V� Date: -3 i g <br /> If- y 3i <br /> Intake Comme 5 Intake Comments: Assign To: ilikile <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> CI Make this a"W"Permit 4OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone '— I <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use SF12. <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? ❑YesNo <br /> Reason Sprinklers Required: "In Lieu" Fee: 'mount$ <br /> Fire Alarm: El Update Existing ❑New System El Not Req'd School Impact Fee: Tota • <br /> Reason Fire Alarm Required: Calculated: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No DEver-• chool Dist ❑Mukilteo School Di <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Addi ional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: aig Date: ?)/2:3/i I1 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <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: tj)2.Li'IQ ❑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 /> Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: 0 This Permit is Approved by Public Works <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ) <br /> El Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: ublic Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: iy,04r, Date: Oil 02 <br />