Laserfiche WebLink
4110 <br /> Intake &Approval Sheet • (FOR PERMIT STAFF ONLY PERMIT#2 11 I I -D 1 D <br /> BUILDING. PLANNING <br /> Intake OK by: Date: 1 Ca , Intake OK by: Assign To: le x Date: 11/(O/j 1 <br /> Intake Comme s: I Intake Comments: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit Ir,2(OK to Route to Other Departments <br /> Bidg/TI/Addn/Rem Size 1 " 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone C—I g- <br /> Number of Stories -C. , Overlay/Agreement <br /> Basement ❑No Oyes, Fin/Unfin Nonresidential Use Offf U_, <br /> Type of Construction 2^ A Residential Use <br /> Occupancy Group B, Proposed No.of Dwelling Units: <br /> Occupancy Load 1 ", Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing El New System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes I No <br /> Reason Sprinklers Required: "In Lie :Type: nt$ <br /> Fire Alarm: !Update Existing El New System ®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 ❑E chool Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: <br /> VALUATION CALCULATION: Total$ 9-0,l <br /> Approved By: t/v V Date: I?il�/l <br /> PUBLIC WORKS / /` <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: ;PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: Date: I I ❑Backflow Prevention for high hazard: <br /> 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: f ❑This project also has a separate concurrent PW Review(Green Folder) <br /> Eire Sprinklers ire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: ,Nt- C�, .e -}'c, S)!it�ciLi-!" 0 This Permit is Approved by Public Works <br /> Yl 2 ( Gi-Ic.,r n , .2,(r r' 1‘,914.1 ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept.Fees: ❑ A Separate PW Permit is Required(Permit#: PW ) <br /> 0 Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> Minimal or No Fire Scope-NO FIRE FEEEc. <br /> Review/Inspece peElIs in a Separate Green Folder(join with this folder for permit issuance) <br /> Review/Inspec' n pe ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: t//(4 l c Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ECTRICAL <br /> Additional Notes: no 5()Ope) <br /> � <br /> Approved By: Date: Approved By: Date: <br />