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Intake &Approval Sheet . (FOR PERMIT STAFF ONL19 • PERMIT#' " `2-C) <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK bye Date: <br /> Intake Comments: Intake Comments: Assign To: <br /> Route to Commercial Building 0 Attach to Project No. <br /> 0 Route to Residential Building ❑ Route to Historic Reviewer <br /> ID Make this a "W" Permit ❑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 i <br /> Basement DNo DYes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No. of Dwe ng Units: <br /> Occupancy Load Total No. of Dwelli • Units: <br /> Fire Sprinklers: 0Update Existing ❑New System DNot Req'd Planning/Lands ape Inspection Required before Final? ❑Yes DNo <br /> Reason Sprinklers Required: r "In Lieu" Fee: pe: Amount$ <br /> Fire Alarm: ❑Update Existing DNew System ❑Not Req'd School Impa-t Fee: Total $ <br /> Reason Fire Alarm Required: Calculate. Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ©Yes 0 No ❑Ever-t School Dist DMukilteo School Dist <br /> Add'RCW 64.55 docs required prior to final? DYes DNo Additi• al Notes: A.0�ceT+iSe. C41 ) <br /> VALUATION CALCULATION: Total $ <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed If: <br /> `❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: �' Date: �'I13/¢o2,0 RBBckf ow Prevention for high hazard: <br /> ///// (dental,medical,animals,mortuary,hospital, <br /> 'supportive housing) <br /> FIRE DEPARTMENT ['Route this folder for PW Review at end --- 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--- Fire Preliminary Review Notice AND EICreate 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 ❑A Separate PW Permit is Required (Permit#: PW <br /> Fire Alarm: OUpdate Existing ONew System 0 Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Update Existing DNew System 0 Not Req'd 0 Is in a Separate Green Folder (join with this folder for permit issuance) <br /> Additional Notes: El 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: Date: <br /> 21/i <br />