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Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) 0 PERMIT 200 41 tiall <br /> BUILDING - PLANNING <br /> Intake OK by: Date: Intake OK by:* Assign To: I 1 LQI44 Date: .7/31/2-0 <br /> Intake Comments: Intake Comments: <br /> frf <br /> Route to Commercial Building 0 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 /fJ7O ,S'f Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size il/,� Zone C 1 <br /> Number of Stories / Overlay/Agreement - _ <br /> Basement ,No ❑Yes, Fin/Unfin Nonresidential UseI/xi-14 beitii- <br /> Type of Construction q Residential Use _ <br /> Occupancy Group Q Proposed No.of Dwelling Units: <br /> Occupancy Load // Total No.of Dwelling Units: <br /> Fire SprinklersAppdate Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes So <br /> Reason Sprinklers Required: "In l "Fee:Type: Amount$ _ <br /> Fire Alarm: AglUpdate Existing El New System El Not Req'd School Impact • Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ['Yes ElYVo El Everett of Dist ❑Mukilteo Sc ist <br /> Add'I RCW 64.55 docs required prior to final? DYes $No itional Notes: <br /> VALUATION CALCULATION: Total$ 7�a*' <br /> Approved By: A Date: 10/6'2,4 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: I PW Worksheet Needed if: <br /> IOSys Dev Eval DTraffic Mit Eval <br /> I, <br /> ❑Site Work or Drainage Proposed <br /> DBackflow Prevention for high hazard: <br /> Approved B Date /2.0 Ze I(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 /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑ A Separate PW Permit is Required(Permit#: PW ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE ' AND ❑ Is located in this folder <br /> El Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(loin with this folder for permit issuance) <br /> lcxReview/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: iArevt )n Date: 8 4/272p ublic Works has no scop ---PW Not Required <br /> Additional Note v g jb 4 /u to <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> Z/ <br />