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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# "W2CO2'0\2 <br /> BUILDING PLANNING, L, <br /> Intake OK by: Date: Zl(�O/20 Intake OK by:t ) Assign To: 'f UGV DateL / _ <br /> Intake Comments: Intake Comments: C0V91 <br /> 2•/o/zo <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> RI Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bldg/II/Add /Rem ize aa4 Sr: 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone 12-"2-,. <br /> Number of Stories Z Overlay/Agreement <br /> Basement ❑No , Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction YR Residential Use 5' <br /> Occupancy Group (a Proposed No. of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: f <br /> Fire Sprinklers: ❑Update Existing ❑New System PlNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes No <br /> Reason Sprinklers Required: "In ' " ee:Type:_ / Amount$ <br /> Fire Alarm: El Update Existing El New System P-Not Req'd School Impact Fee: $ <br /> Reason Fire Alarm Required: Calculated: edit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 13 No ❑ verett School Dist ❑Mukilteo Schoo • <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes �'No Additional Notes: <br /> VALUATION CALCULATION: Total$ 6 l` wc, <br /> Approved By: v vb Date: 21 i 6/244) <br /> PUBLIC WORKS <br /> Intake OK by:MA Date: 2-lib I St, <br /> Additional Notes: Z.0 /s— `gG ir f'NJSogc Intake Comments: =PW Worksheet Needed if: <br /> V•1'CE�-.0 woc•-.� =)]Sys Dev Eval ❑Traffic Mit Eval <br /> 4ei.o <br /> =DSite Work or Drainage Proposed <br /> Approved By: Date: 4/ ,� �\& ` ig-% g ,a ow Preventioorh��" =(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 /> .g <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 A Separate PW Permit is Required(Permit#: 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: CziPublic Works has no scope---PW Not equired <br /> Additional Note 2 /16 120� <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />