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11110 <br /> Intake &Approval Sheet (FOR PERMIT STAFF ONL • PERMIT# �� <br /> pP � <br /> BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To:41-e7�'/ <br /> Date:)1/4/14 <br /> Intake Comments: Intake Comments: <br /> Plinnif1 COO aep r elyvl++. e)(-*nor Urlffs <br /> rwt i I v w�(I anc1 Pl e0 R9 rcyrol g&t1a c c.. <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit g OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone C— I <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use CQyh Y eCC;aJ <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: ❑Update Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ('No <br /> Reason Sprinklers Required: "In " ee:Type: t$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee. tal $� <br /> Reason Fire Alarm Required: Calculated: Z�reatt: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ e School Dist ❑Mukilteo School Dls <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ /7 ?gJ.OV <br /> Approved By:6K Date: 11 /7/i ! <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> OSys Dev Eval OTraffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> Approved By: r Date: ///O7/Zai9 OBackflow Prevention for high hazard: <br /> (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 ❑Fire Alarm ®Othe Peiverajd AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <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 B • f • Date://A/ZO/9 ❑ Public Works has no scope PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />