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Intake & Approval Sheet S (FOR PERMIT STAFF ONLY) I PERMIT#V20l -13 1 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by( Assign To: i\‘‘e\S Date: A. 0 <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 ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size Z Sr( f'S , / El Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size it/44 Zone <br /> Number of Stories / Overlay/Agreement <br /> Basement 14No ❑Yes , Fin/Unfin Nonres <br /> Type of Construction i-II Reside VeA <br /> Occupancy Group .�'/ 1 5 Propos <br /> Occupancy Load S G' `' Total N k)\� , IS <br /> Fire Sprinklers: El Update Existing New System El Not Req'd Planni 1 ❑Yes El No <br /> Reason Sprinklers Required: "In Lie! ' <br /> Fire Alarm: El Update Existing,®New System El Not Req'd Schoo <br /> Reason Fire Alarm Required: Calcul <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes lN No ❑Eve CfaVtf\AVj-- <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes . t No Additii <br /> VALUATION CALCULATION: Total $ /g % M <br /> Lz Z,/ 7,i a" x 07 7 - ick-i`S ? �—Z_ <br /> 1---- <br /> #' Appr <br /> / <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: IPW Worksheet Needed if: <br /> IOSys Dev Eval ❑Traffic Mit Eval <br /> OSite Work or Drainage Proposed <br /> }(: ). <br /> Approved B , Date: s/z�?� O Backflow Prevention for high hazard: <br /> j(dental,medical,animals,mortuary,hospital, <br /> Isupportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ,fire Sprinklers Wire Alarm ❑Other: AND El Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: ❑ 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 ) <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: ate:///7.&z 7 ❑ Public Works has no scope--- PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />