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Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) . PERMIT# N6 l \2 1,!,) <br /> BUILDING PLANNING <br /> Intake OK by: 7 Date: a77-11/ Intake OK by:6'4i Assign To: Gl(a_CQ Date: !2/J3Acl <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. 1\l_ `" - !e)1 0 <br /> ❑ Route to Residential Building 0 oute to Historic Reviewer <br /> ❑ Make this a"W"Permit K to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> e.rage' ccessory Struct.Size S'z. 53‹ Zone f 2-— f <br /> Number of Stories Overlay/Agreement <br /> Basement 1iINo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use SFR. <br /> Occupancy Group vl Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: I <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 94o <br /> Reason Sprinklers Required: "In ' "Fee:Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: <br /> Reason Fire Alarm Required: Calculated: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes til No ❑Ev School Dist ❑Mukilteo School <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: <br /> VALUATION CALCULATION: Total$ Sy 7..?40 <br /> Approved B _______:;C"). Date: \2,\Q, 2Q`9 <br /> PUBLIC WORKS <br /> Intake OK by: Date: f' et // <br /> Additional Notes: Z0/5 /AG Intake Comments: 1PWWorksh Needed if. <br /> j,„, <br /> �Z 0�/3 ICA i❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: at Date: �+6 /q <br /> El_, <br /> 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 /> See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: A Separate PW Permit is Required (Permit#: PW tR 1 Z' 037) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND Is-.located in this folder <br /> 0 Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE 0 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:Approved By: Date: Approved By: /Date: /2 6 oho/9 <br />