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Intake &Approval Sheet * (FOR PERMIT STAFF ONLY) I PERMIT#Ir t 2001— OI <br /> BUILDING - PLANNING <br /> Intake OK by: Date: Intake OK by:06 Assign To:P'104 Date://24/20 <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building 0 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 <br /> Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use �I k <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: El Update Existing ❑New System Mot Req'd Planning/Landscape Inspection Required before Final? ❑Yes No <br /> Reason Sprinklers Required: ieu"Fee:Type: Aarrt <br /> Fire Alarm: El Update Existing El New System El Not Req'd School Impact Total <br /> Reason Fire Alarm Required: Calculated: dit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Ever chool Dist ❑Mukilteo Schoo <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No ditional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: j 1 2r1 <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: trZ. rw � l?t Intake Comments: IPW Worksheet Needed if: <br /> IDSys Dev Eval ❑Traffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> � <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: jr-r7. Date: it 5/6L"242` (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 /> El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> 0 This Permit is Approvedby ' <br /> Additional Notes: �; 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 Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> O 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 0 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: <br /> Approved By: Date: Approved By: Date: <br />