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41/ ` rO <br /> Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) f�,�`PERMIT# v 0i O'. <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK byclit Assign To: tN. , Date:1 / i /2-I , <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size S 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size_ — Zone g-Z <br /> Number of Stories 4 Overlay/Agreement <br /> Basement EINo ❑Yes, Fin/ nfin Nonresidential Use <br /> . Type of Construction V s Residential Use S <br /> Occupancy Group . - Proposed No. of Dwelling Units: - ' <br /> Occupancy Load Total No.of Dwelling Units: I <br /> Fire Sprinklers: ❑Update Existing El New System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes JGtI�Vo <br /> Reason Sprinklers Required: "In L'-u"Fe:. ype: Amount$ <br /> Fire Alarm: ❑Update Existing ONew System tlNot Req'd School Im,aact '-e: Total ': Ailk <br /> Reason Fire Alarm Required: Calc lat:d: redit: lipr <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No ❑E - eft School W ❑Mukilte. - ool Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes 111 No Additional Notes: <br /> VALUATION CALCULATION: Total$ 'Oj BLo41=, <br /> 2 s a.. .t MC t = eo•4-42t 2- ,,,,�� <br /> � - '` -�q-I - a '' Approved By:A Date:4 )3, 2.A� <br /> (�/""���� PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: 1 PW Worksheet Needed if: <br /> �DSys Dev Eval OTraffic Mit Eval <br /> =(]Site Work or Drainage Proposed <br /> )Approved By: Date: • //2D2_..jOBackflow Prevention for high hazard: <br /> (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 El Deferred <br /> Additional Notes: =/ his Permit is Approved by Public Works <br /> IN 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 scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: Ali Approved By: Date: Approved By: xi Date: II ZNIf 94 <br />