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• <br /> • <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1(.` o <br /> BUILDING PLANNING <br /> Intake OK by: Date: `/// i / 7 Intake OK by Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ia Route to Commercial Building � L•.) - ❑ 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 <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 4 nits: <br /> Occupancy Load Total No.of Dwelling its: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landsca.- Inspection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Ty. : Amount$ <br /> Fire Alarm: El Update Existing El New System ❑Not Req'd School Impact 'ee: Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Evere• School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: <br /> VALUATION CALCULATION: Total$ 3 27 0O6..00 <br /> cb>,‘,(4 L Approved By: Date: 1/ f <br /> &Vita. Lam es <br /> L.-, PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Neede- if: <br /> __- --� <br /> ❑Sys Dev Eval 2 Traffic Mit Eval <br /> ❑Site Work • 'rainage Proposed <br /> ❑Backfl• Prevention for high hazard: <br /> Approved B Date: //07/7.o/q <br /> (dent- edical,animals,mortuary,hospital, <br /> su••ortive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Revie, .t end ---PW Review Worksheet <br /> Separate I Deferred Submittals Required: ❑This project also has a sep. ate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm Dot - : AND ❑Create Green Fo.er ❑Submitted Previously ❑Deferred <br /> Additional Notes: ❑ This Permit is Apo •ved by Public Works <br /> ❑ See PW Revi:' Worksheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separat: W Permit is Required (Permit#: PW <br /> ❑ Review of As-:, t Plans-NO FIRE FEE AND ❑ located in this folder <br /> )51 Minimal or ''o Fire Scope-NO FIRE FEE ' Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Revie /Inspection Scope-ADD FIRE FEE ■ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 117 .2 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: a547 <br />