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• <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# ) 0 'Oq I. <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by://g Assign To: ®'". Date: I Zg/2.-eJ <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ oute to Historic Reviewer <br /> ❑ Make this a"W"Permit .OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0,4 4 - ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size — Zone j--2 <br /> Number of Stories 2_ Overlay/Agreement <br /> Basement INo Oyes, Fin/Unfin Nonresidential Use <br /> Type of Construction V— Residential Use 11V1 f��— / ✓j tJf�1� <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: �,{ <br /> Fire Sprinklers: ❑Update Existing ID New System KNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ]�No <br /> Reason Sprinklers Required: tMu <br /> eu" e :Type: Amount$ /// <br /> Fire Alarm: ❑Update Existing ❑New System ®Not Req'd ol mpa t Fee: otal <br /> Reason Fire Alarm Required: ran u ated:RCW 64.55 MF worksheet req'd for permit? ❑Yes J No erett Scho istkilteo School ist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes I=!No ional Notes: <br /> VALUATION CALCULATION: Total$ ce - <br /> 8"4x <br /> Approved By: Date: J i I <br /> PUBLIC WORKS /2-0?-4 <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: iPW Worksheet Needed if: <br /> i❑Sys Dev Eval OTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: *j221.212A ❑Backflow Prevention for high hazard: <br /> I(dental,medical,animals,mortuary,hospital, <br /> isupportive housing) <br /> FIRE DEPARTMENT El 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> • <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 /> ❑ 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: Public Works has no scope---PW Not Required <br /> A ditional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: ik\k Date: 111 IA <br />