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Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# I' 6-6 " <br /> _ BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: .IS/ i- Date: KJ/2r7l/ <br /> 2 <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 AOK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size (Off', 22� _ El Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size — Zone E—I MOO O 0 <br /> Number of Stories C _ Overlay/Agreement <br /> Basement IOW ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction '_-A - (1 Residential Use 01'h4 fretrIAIN <br /> Occupancy Group S-2- i _ -.- Proposed No. of Dwelling Units: —76 <br /> Occupancy Load 'e'-6 Total No. of Dwelling Units: 70 <br /> Fire Sprinklers: ❑Update Existing IXINew System ❑Not Req'd Planning/Landscape Inspection Required before Final? es ❑No <br /> Reason Sprinklers Required: R-z "In Lieu"Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing %A New System El Not Req'd School Impact Fee: Total $ q 0 + .500 <br /> Reason Fire Alarm Required: 3 cc:Fcl-` Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? IYes ❑ No ,verett School Dist ❑Mukilteo School Dist <br /> Add!RCW 64.55 docs required prior to final? ail Yes El No Additional Notes: 3ci�j \N.fe t;,k' G5 (pmtA <br /> VALUATION CALCULATION: Total$ tom)284,R1 R Z��� �'v��i'j "7 <br /> (-To, (Q 05)( t t 5-) = l o,�I R, S�-s l.M� � r y"1�6`�C�C� <br /> C i `i-, v2 4F� ( l 0> _ d 8to'a,1441 Approved By: t..1 I Date: 42.l°'14 <br /> UBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: Works beet Needed if: <br /> I❑Sys Dev Eval OTraffic Mit Eval <br /> I❑Site Work or Drainage Proposed <br /> Approved By: Date: ,&,--rS ��,I <br /> I❑Backflow 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 /> Rlizice Sprinklers .jre Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: El This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW 2011^°Li Li ) <br /> o 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(jait,with this folder for permit a-Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:K.12) A Date: J J-3:2O,20 ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />