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0 <br /> • nI�9 2002-0 0 <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# DUv <br /> BUILDING PLANNING • <br /> Intake OK by: d Date: Z/2 /zo Intake OK by: G%t/ Assign To:77(1-1)6 Date:2/2 2X <br /> Intake Comments: Intake Comments: / <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> Er Make this a"W" Permit XOK to Route to Other Departments <br /> Bldg/TI/Addn em ize 2..ci 0 I •f✓ ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size i' Zone <br /> Number of Stories Z Overlay/Agreement <br /> Basement ❑No EYes, Fi /Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group IL Proposed No. of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: <br /> Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ElYeso <br /> Reason Sprinklers Required: ,"In ee: Type: Amo <br /> Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fee: al $ <br /> Reason Fire Alarm Required: Calculated: edit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 1l No ❑Evere Dist ❑Mukilteo Scho <br /> Add'I RCW 64.55 docs required prior to final? ❑YeS 21 No ditional Notes: IA-DJ n at-pem-t)-I-kp( r <br /> s-eV1,44/1f . <br /> VALUATION CALCULATION: Total$ l di8110 vielg( ffn t- 9(1 c if a,pp(o&1 �{7 -t-n c 12e-nryt d- . <br /> /11.F iaDi3 e S r, (��L�' SC) 1`t1 gcx> I f C <br /> Lit-- Seel 4' Approved By: ( Date: i2--/L/LQ2 <br /> 4..F IOOt� C�'100 <br /> i�Z�t yx» <br /> Ma* 1 2-1 e-2S 3 t t90 'CV PUBLIC WORKS <br /> ntake OK by: Date: U� <br /> Additional Notes: LOV$- t/2C_ 16 Gtis c• , Intake Comments: I PW Worksheet N, eded if: <br /> `.' llcSys Dev Eval ?❑Traffic Mit Eval <br /> No p 1DSite Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> Approved By: �' Date: /fG�/per (dental,medical,animals,mortuary,hospital, <br /> (supportive housing) <br /> FIRE DEPARTMENTRoute 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> 0 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 /> ❑ 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: p Public Works has no scope---PW Not Required <br /> Additional Note .3` flZ.o vo <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> �7 <br />