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• <br /> ct, <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# J\ct -oa <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <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 <br /> Number of Stories Overlay/Agreement <br /> Basement El No ❑Yes, Fin/Unfin Nonresidential Use <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: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes o <br /> Reason Sprinklers Required: "In Lieu e: / Amount$ <br /> Fire Alarm: El Update Existing ONew System El Not Req'd School Impact Fee: <br /> Reason Fire Alarm Required: Calculated: Cre i . <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ ett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ mdruo (oic iar Iaciot1rs • Nu -2xle-r/YW'Y <br /> Approved By: A Date: 1 /30/1q <br /> PUBLIC WORKS// <br /> Intake OK by:— 4'rt1 Date: o ill <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> i�"t'�2.0� vvot�►� 'DSys Dev Eval ❑Traffic Mit Eval <br /> o•►%-'`' IDSite Work or Drainage Proposed <br /> Approved By: Date: =❑Backflow Prevention for high hazard: <br /> 77g70/ici 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 /> El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ODeferred <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: Via, Date: 9 /f ublic Works has no scope--- PW Not Required <br /> I Additional Notes: 1 /3d (i C <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />