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Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) 410 PERMIT# 82 e 66°) <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: J(IA Date: ►a/ / <br /> Intake Comments: Intake Comme ts: <br /> Cl Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ R ute 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 ❑Yes, Fin/Unfin Nonresidential Use <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: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No <br /> Reason Sprinklers Required: "In Lieu"Fe .T pe: Amount$ <br /> Fire Alarm: El Update Existing ❑New System El Not Req'd Schbol Im act F•e: T. . $ <br /> i <br /> Reason Fire Alarm Required: Calqulat d: /Credi : <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑E ett School_t ukilteo Sc I Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: lip Date: —7/2 J42_) <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: S►C.►*.1 lei INM JTe . &NV Intake Comments: PW Worksheet Needed if: <br /> i-, izt.u‘t.ott,sei PegMcr. <br /> kJ R ew tit. v`0.�• s(]Sys Dev Eval ❑Traffic Mit Eval <br /> ldl;?v S4 !Mite Work or Drainage Proposed <br /> Approved By: Date: ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> Isupportive housing) <br /> FIRE DEPARTMENT ❑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 /> El Fire Sprinklers ❑Fire Alarm DOther: 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: ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> 2/2 <br />