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Intake &Approval Sheet . (FOR PERMIT STAFF ONLI�) . PERMIT# QJ� l(i --co c <br /> BUILDING t PLANNING <br /> Intake OK by: Date: tI/�-]• lel Intake OK by: Ad›. Assign To:11 (£)7 Date:1 l/4//1 <br /> Intake Commei� ((( Intake Comments: <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> Route to Residential Building -To s 1= ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit LK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size 720 5J4 Zone -I <br /> Number of Stories r Overlay/Agreement <br /> Basement I No ❑Yes, Fin/Unfin Nonresidential Use '— <br /> Type of Construction ME' Residential Use 5 f'r <br /> Occupancy Group lot Proposed No.of Dwelling Units: — <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes %o <br /> Reason Sprinklers Required: "In ee:Type: A <br /> Fire Alarm: CI Update Existing ❑New System ❑Not Req'd School Impact Fee: tal $ <br /> Reason Fire Alarm Required: Calculated: edit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes l.No ❑ chool Dist ❑Mukilteo School <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes t9No Additional Notes:?1e 1'1 <br /> 0 6vtV ' 1°la(Jr . <br /> VALUATION CALCULATION: Total$ 3�S( 0 �(( jj <br /> l 2.0)e L4 O Approved By: Date: 31 12.6 <br /> t d <br /> PUBLIC WORKS <br /> Intake OK by:1 a.1 Date: I t 1 4 120 t4 <br /> Intake Comments: WSorksheet if: <br /> Additional Notes: 2 Q/S- /AC <br /> Mt <br /> !�- ys Dev Eval OTraffic Mit Eval <br /> s b V—t J—`•-+�-e- l $ite Work or Drainage Proposed <br /> A-P*P A-1 L.,a,�.t,-r —r "P¢,Ji o Backflow Prevention for high hazard: <br /> Approved By: Sib Date: Il` P/ .D;LA V E.wA-7, Act-.r.Rental,medical,animals,mortuary,hospital, <br /> �. T ;supportive housing) <br /> FIRE DEPARTMENT CI Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate i Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Cl Fire Sprinklers CI Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> This Permit is Approved by Public Works <br /> Additional Notes: `, <br /> XSee PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: K-A Separate PW Permit is Required(Permit#: PW 0 .2—035 ) <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND A Is located in this folder <br /> ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: ❑ Public Works has no scope---PW Not Required <br /> Additional(4 list, <br /> f nw an B/Ij f imnl-1" 'i.a$ <br /> ELECTRICAL D>✓11 9 <br /> Additional Notes: <br /> Add. -ft .OI°�II-WI. <br /> Approved By: Date: Approved By: ji-E.,-&- Date: ,Izjimezt, <br />