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0 <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY • PERMIT# V q Ob"l'A <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by:--��- — Date: /i V7t!P1 <br /> Intake Comments: Intake Comments: Assign To: no4 <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> ❑ Make this a"W"Permit K to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone i l <br /> Number of Stories Overlay/Agreement —� <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use til f <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: DUpdate Existing ❑New System ONot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu"Fe :Type: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee. Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No 0 School Dist ❑Mukilte School Dist <br /> Addl RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ Zo4 0O4, 00 <br /> Approved By: I') Date: o f l i /j q <br /> PUBLIC WORKS / <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> DSite Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved B „ Date:6%406/20/9 (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute 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 Pla : -NO FIRE FEE AND 0 Is located in this folder <br /> ❑ Minimal or No Fire :cope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Insp-, ion Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved B Date: PI Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Ad- tional No l , / <br /> Approved By' Date: ®, `/ Approved By: ' i�(� Date: 0 9/ (6 <br />