Laserfiche WebLink
Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLr • PERMIT # ?AZ> k 1k \ —CJ/PN <br />BUILDING <br />Intake OK by: Date: (( /ZZ-,/( at <br />Intake Comments: <br />❑ Route to Commercial Building <br />Is Route to Residential Building <br />❑ Make this a "W" Permit <br />Bldg/TI/ Rem Size <br />Garage/Accessory Struct. Size <br />.5 8153 S <br />Number of Stories <br />3 <br />Basement <br />CgNo ❑Yes , Fin / Unfin <br />Type of Construction <br />Occupancy Group <br />AA <br />Occupancy Load <br />Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd <br />Reason Fire Alarm Required: <br />RCW 64.55 MF worksheet req'd for permit? ❑Yes 5TNo <br />Add] RCW 64.55 docs required prior to final? ❑Yes EgNo <br />VALUATION CALCULATION: Total $ 1 <br />46 Si tR Ot <br />S6oS& 17-1 43-11+57 <br />i <br />Additional Notes: 4 tkJ S4--_ <br />Approved By: Date: Z <br />FIRE DEPARTMENT <br />Separate / Deferred Submittals Required: <br />El Fire Sprinklers ❑Fire Alarm ❑Other: <br />Additional Notes: <br />Fire Dept. Fees: <br />❑ Review of As -Built Plans - NO FIRE FEE <br />❑ Minimal or No Fire Scope - NO FIRE FEE <br />❑ Review / Inspection Scope - ADD FIRE FEE <br />Approved By: Date: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: <br />PLANNING <br />Intake OK by:045Assign To:a_._v____ Date: <br />Intake Comments: <br />❑ Attach to Project No. <br />❑ Route to Historic Reviewer <br />qOK to Route to Other Departments <br />❑ Hold in Planning File Drawer <br />Zone - 2 <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />U <br />_ <br />1 rl f 1 k. <br />YVW' - <br />Proposed No. of Dwelling Units: <br />-'--- <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? <br />❑Yes No <br />" n " ee: Type: Am <br />School Impact Fee: <br />:7! <br />Calculated: Cre <br />❑Ev cho )I Dist ❑Mukilteo School Dist <br />Additional Notes: <br />Approved By: <br />Date: 2 112-0 <br />PUBLIC WORKS <br />Intake OK by: I Date: I( 2 I 1 t 9 <br />..................... .................................,...............,....,......,....,........,...,,.,,,, <br />Intake Comments: PW Worksheet Needed if. <br />0, cyDtT to `I 6y SDev E2val (]Traffic Mit Eva[ <br />-p�tv �waKs <br />06e Work or Drainage Proposed <br />t 4q 4 ,.aEw <br />❑Backflow Prevention for high hazard: <br />5 ULrACf :(dental, medical, animals, mortuary, hospital, <br />;supportive housing) <br />€ ........................ ..................... .... ............. ,...................... ............................... <br />.......................... <br />...... <br />Route this folder for PW Review at end --- PW Review Worksheet <br />❑This project also has a separate concurrent PW Review (Green Folder) <br />AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br />rr,,�� This Permit is Approved by Public Works <br />I4 See PW Review Worksheet and associated attached items <br />2v8-c> i <br />A Separate PW Permit is Required (Permit #: PW <br />AND RU located in this folder <br />❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) <br />❑ WIII be issued separately (separate Green Folder, PW issued ahead of Bldg) <br />❑ Public Works has no scope --- PW Not Required <br />Additional Notes: <br />Approved By: a e: ® O <br />