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0 0 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S2b b I ' 66 I <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:0/ Assign To: &X Date: ( /� 2 C <br /> Intake Comments: Intake Comments: 6.v v//,�/ ((( <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone C I <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Dtvri. I ((2� <br /> Type of Construction Residential Use -- <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ['Update Existing ❑New System [hot Req'd Planning/Landscape Inspection Required before Final? ❑Yes <br /> Reason Sprinklers Required: "In Lieu :Types_ Amount$ <br /> Fire Alarm: El Update Existing El New System CI Not Req'd School Impact Fee: Tate <br /> Reason Fire Alarm Required: Calculated: 't: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No El Ever chool Dist ❑Mukilteo School ist <br /> Add'RCW 64.55 does required prior to final? ❑Yes ❑No dditional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: (i3 Date: \ / / Q <br /> PUBLIC WORKS (l <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> OSys Dev Eval ❑Traffic Mit Eval <br /> i OSite Work or Drainage Proposed <br /> Approved By: icir Date: (/ j{(p/pZ.Q''tA IDBackflow 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 /> Separate/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: ❑ This Permit is Approved by Public Works <br /> 0 See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit II: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ 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: 0 Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />