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Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT # 2,00 (-MLk <br />BUILDING <br />Intake OK b Date: 0//eZhQJ <br />Intake Comments: <br />Route to commercial Building <br />Route to Residential Building <br />M <br />.ake this a "W" Permit <br />Bid Cffl�ddn/Rern Size <br />1­1 <br />Oarage/AccessoryStruct. Size <br />Number of Stories <br />Basement <br />0No ILes, Fin/ Unfin <br />Type of Construction <br />Occupancy Group <br />Occupancy Load <br />Fire Sprinklers: 01-113date Existing ONew System f9 Not Req'd <br />Reason Sprinklers Required: <br />Fire Alarm: . 0 Update Existing El New System RINot Req'd <br />Reason Fire Alarm Required: <br />RCW6.4.55 MF worksheet req'd for permit? Oyes ��No <br />Add'l RCW 64.55 does required prior to final? []Yes, BNo <br />VALUATION CALCULATION: Total $ <br />Additional Notes: <br />4AP Ale,5os 7-a 4,Ahv=or- "xr <br />IlApproved Date:,�9 ±!Llao-Zo <br />1J <br />FIRE. DEPARTMENT <br />Separate / Deferred Submittals Required: <br />OFire Sprinklers DFire Alarm ElOther: <br />Additional Notes: <br />Fire Dept. Fees: <br />El 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 />pproved By: <br />Date- <br />=L.Z <br />PLANNING <br />Intake OK b9-L-1 Assign To��,f Date: <br />Intake Comments: <br />El Att ect No. <br />.,Route to Historic Reviewer <br />toric <br />rHold <br />te <br />OK to R7oute o S <br />El in Planning File Drawer <br />Zone <br />Overlay/Agreement <br />Nonrastclurftiritt1se <br />WA \\�%\Sms(! &%%_k, <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Planning/Landscape Inspection Required before Final? []Yes 0No <br />"In Lieu" Fee: Type: <br />School Impact Fee: Total <br />Calculated: Credit: <br />j- *ool Dist []Mukilteo School Dist <br />D Everett S <br />Additionallotes: <br />xck *4, C5 W <br />(�,& , 9 n <br />IlApproved, y. Date: -�3"Zes, 2iz)zo <br />PUBLIC WORKS <br />Intake OK by: Date: <br />...... ..... I ... . ....... ........... . . <br />Intake Comments: PW Worksheet Needed if., <br />[]Sys Dev Eval OTraffic Mit Ev.11 <br />0 Site Work or Drainage Proposed <br />0 Backflow Prevention for high hazard: <br />medical, animals, mortuary, hospital, <br />-supportive housing) <br />............ .......... . .......... . .... . .............. . ........ . . . . ........ . ..................... . ........ . ....................... . . <br />El Route this folder for PW Review at end --- PW Review Worksheet <br />ElThis project also has a separate concurrent PW Review (Green Folder) <br />AND OCreate Green Folder OSubmitted Previously DDeferred <br />This Permit is Approved by Public Works <br />See PW Review Worksheet and associated attached items <br />A Separate PW Permit is Required (Permit #: PW <br />AND El Is located in this folder <br />Is in a Separate Green Folder Coin with this folderfor permit issuance) <br />Will be issued separately (separate Green Folder, PW issued ahead of Bldg) <br />Public Works has no scope --- PW Not Required <br />];P =Z,5L,70 Additional Notes: <br />ELECTRICAL <br />Additional Notes: <br />Approved By: Date: Apt <br />By: Date: <br />el <br />f, <br />