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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 'pZZ 0 �--.If7--10 <br /> BUILDING PLANNING <br /> • <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> • <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 ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No • es, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No.of Dw: ing Units: <br /> Occupancy Load Total No.of Dwel• g Units: <br /> Fire Sprinklers: DUpd. - Existing ONew System ❑Not Req'd Planning/Lan. cape Inspection Required before Final? Oyes ❑No <br /> Reason Sprinklers 'equired: "In Lieu"Fe:.Type: Amount$ <br /> Fire Alarm: ■Update Existing ONew System ❑Not Req'd School I .act Fee: Total $ - <br /> Reason Fi - Alarm Required: Calcul.. ed: Credit: <br /> RCW 6 .55 MF worksheet req'd for permit? ❑Yes rg-No ❑. erett School Dist ❑Mukilteo School Dist <br /> A.. RCW 64.55 docs required prior to final? ❑Yes l No dditional Notes: <br /> C <br /> VALUATION CALCULATION: Total$ f '1v"))P, Y Iil <br /> 9 <br /> Approved By: Date: <br /> PUBLIC WORKS <br /> Intake OK by: . Date: <br /> Additional Notes: Intake Comments: Worksheet Needed if: <br /> _ Sys Dev Eval ❑Traffic Mit Eval <br /> DSite Work or Drainage Proposed <br /> Approved By: Date: Vi.c..),417, <br /> _I�Backflow 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: 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 By: Date: aPublic Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: /if( <br /> 7 <br />