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Intake & Approval Sheet (FOR PERMIT STAFF ONLY • PERMIT# 2eoa _OLM <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <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 1 c:;;[4 ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories 1— Overlay/Agreement <br /> Basement IONo ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction V Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: t <br /> Fire Sprinklers: CI Update Existing ❑New System P3 Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No <br /> Reason Sprinklers Required: ' Lie e:Type: mount$ <br /> Fire Alarm: ❑Update Existing ❑New System Not Req'd S ho Imp ct Fe : Total <br /> Reason Fire Alarm Required: C lc lated: Cre it: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No erett Sc o I Dist ❑Mu 'It Schoo •st <br /> Add'I RCW 64.55 does required prior to final? ❑Yes MNo Additional Notes: <br /> VALUATION CALCULATION: Total $ ►�3i 11') <br /> tc;14- x (2_( = <br /> Approved By: 1/ Date: \ _Z tl✓ 7 j ea.0 <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 /> ❑Site Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: : Date: . OZD2_,1 (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 OCreate Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: El This Permit is Approved by Public Works <br /> ITiSee 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 /> Er 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: K.66-6w-, Date: L2'15,24 ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: J2 <br /> 2/Z <br />