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Intake &Approval Sheet 0 (FOR PERMIT STAFF ONL19 • PERMIT#T2 205e6-6 2. <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Dated f2'{2-0 <br /> Intake Comments: Intake Comments: <br /> mAtt 'itics tc 44kg 11-41141+44 `f" <br /> 41441+ ceittre e -61,- , <br /> Math luvilolw>? <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 s 32,t"l Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size .- Zone 1.,—-I P <br /> Number of Stories J.. Overlay/Agreement <br /> Basement s®No ❑Yes, Fin/Unfit' Nonresidential Use VAni I <br /> Type of Construction Y-tj Residential Use <br /> Occupancy Group K i '> Proposed No. of Dwelling Units: <br /> Occupancy Load A-i Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing El New System 1131Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: IX Update Existing El New System El Not Req'd Schoo Total $ <br /> Reason Fire Alarm Required: "2" 3G �k-z <br /> IN Calculated: dit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes IN No ❑ School Dist ❑Mukilteo School Dis <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes f No Additional Notes: <br /> VALUATION CALCULATION: Total$ 1 2-5 L CAD <br /> Approved By: (44), Date: <br /> 1(/)0/2 <br /> " �' PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: I PW Worksheet Needed if: <br /> IOSys Dev Eval ©Traffic Mit Eval <br /> i <br /> 3❑Site Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: Date: I o f 0122b,2 7 i(dental,medical,animals,mortuary,hospital, <br /> (2fd(d-o2-1) '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 /> klSee PW Review Worksheet and associated attached items tJ/j <br /> Fire Dept. Fees: gt A Separate PW Permit is Required (Permit#: PW 200-02O ) <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 coin 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: ,,1?)(15w,r) Date:.a2j,67e, ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: M Date: ('O rtk 12 U <br />