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Intake &Approval Sheet • (FOR PERMIT STAFF ONLY S PERMIT# �w I1/1— 603 <br /> BUILDING PLANNINGI <br /> Intake OK by Date: // D r//ZO/9 Intake OK by: Assign To:fr &) Date: ))/4/i' <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 q}OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/ ccesso trust. Size 256 .r. Zone P—Z <br /> Number o tories 1 Overlay/Agreement <br /> Basement INBo ❑Yes, Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use c <br /> Occupancy Group u Proposed No.of Dwelling Units: <br /> Occupancy Load Total No.of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes KlNo <br /> Reason Sprinklers Required: "In Lle Type:` Amo nt$ <br /> Fire Alarm: ❑Update Existing ❑New System CI Not Req'd School Impact Fee: I� <br /> Reason Fire Alarm Required: Calculated: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ,.,, :,No ❑E tt School Dist ❑Mukilteo School Dis <br /> Add!RCW 64.55 docs required prior to final? ❑Yes aJo Additional Notes: <br /> VALUATION CALCULATION: Total$ 69®® <br /> Approved By: o/]S Date:3/U/2 <br /> F/��� PUBLIC WORKS ((( <br /> Intake OK by:l M Date: "-8I 14 J zc ,4 <br /> Additional Notes: 20/S7R.C., Intake Comments: IPW Worksheet Needed if <br /> AV -"r+ W add at-14- ❑Sys Dev Eval ❑Traffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> Approved By: Date: )�3%j� IDBackflow 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 /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: El This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: 0 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 sco e---PW Not Required <br /> Additional Notes; i i byl /f 1 <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />