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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# S t� ' OO <br /> BUILDING ,//�� PLANNING �r <br /> ��iV� !`i W)d Date: 1213A �1 <br /> Intake OK by: Date: Intake OK by: Assign To: <br /> Intake Comments: Intake Comments: <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 15-2- <br /> Number of Stories Overlay/Agreement — <br /> Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use 3i-D6.P.,'-f d in"€ <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 ❑Not Req'd Planning/Landscape Inspection Requires .b'efore Final? ❑Yes tiNo <br /> Reason Sprinklers Required: "In Lie e:Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System El Not Req'd School Impact Fee. 1 <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Eve School Dist ❑Mukilteo eoLDist <br /> Add'i RCW 64.55 docs required prior to final? ❑Yes ❑No A ditional Notes: <br /> VALUATION CALCULATION: Total$ Idea 40 <br /> Approved By: Date: 12. 8/1 I <br /> PUBLIC WORKS <br /> Intake OK by: Date: /Z <br /> Additional Notes: Intake Comments: iPW Worksheet Needed if: <br /> IUSys Dev Eval ❑Traffic Mit Eval <br /> 1 0Site Work or Drainage Proposed <br /> Approved B Date: /v...A�/ /? I l]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: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El 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 /> 2.14._ <br />