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Intake &Appval Sheet )(FOR PERMIT STAFF ONLY) ' ro] PERMITit Bzzo3-o0l <br />BUILDING <br />PLANNING' <br />Intake OK by: Date: <br />Intake Comments: <br />❑ Route W Commercial Building <br />❑ Route to Residential Building <br />❑ Make this a "W' Permit <br />Intake0 y: Assign To; Q l Date: SGs <br />Intake ants: <br />❑ Atiach to Project No. <br />❑ Route to Historic Ravlewer <br />❑ OK to Route W Ogler Departments <br />❑ Hold In PlannIn File Drawer <br />BIdgRllAddrvRem Size <br />Garage//ucessory Struct. Sin <br />AIM <br />Zone <br />Numberof Stories <br />2 <br />Overeeftmement <br />Basement <br />Wks ElYes, Fin I Life <br />Nonresidential Use <br />Type of Construction <br />ZIC< <br />Residential Use <br />Occupancy Group <br />tKL <br />Proposed No, of Duelling Units: <br />Occupancy Load <br />Total No. of Dwellln Units: <br />Fire Sprinklers: ElUpdate Erbling ONaw System FINot Rand <br />Planning/Landscape Inspection Requlretlbefore Fin el as ONc <br />Reason Sprinklers Requires: <br />"In Lieu" Fee: Type: Amo <br />Fire Alarm: <br />❑ Update Existing ONeM system Not RegM <br />School Impact Fee: Taint $ <br />Calculated: redit <br />DEverelt School Dlsl Mukllteo School Dist <br />Reason Fire Alarm ulred: <br />RCW 64.56 ME wixkcheat mq'd for mark? Elyse Iqqp No <br />dd'I RCW".66 does required pdorto Inali Oyes ®No <br />Addk orm NoWs:(ar ce'5 rm+uwN+�'B about Me regvired <br />2 Parkl.+y s aces have been trddresseA to khe <br />Rvksed s¢t. OY 4w lssvc <br />ALUATION CALCULATION: TaWI j 6da, oze <br />[Approved Date: S, <br />- - PUBLIC WORKS' <br />Intake OK by: Date: <br />Intake Comments: PW Worksbeet Needed H.. <br />E]Sys Dev Eval OTra(fle MIt1bat <br />EISlte Work of Drelnege Proposed. <br />OBeckfaw Preventionfishighh®N: <br />(dmltl, meEkai. milmele, m0anne hoepnel, <br />auprydNa M1wplagl <br />I]Roate this folderfor PW Review at end— PWRevlew Worksheet <br />LIThIs project also has a separate concurrent PW Review (Green Fader) <br />AND L]Cmam Green Folder ElSubmittsd Previously I]Defened <br />Additional Notes: <br />pprovedB. Date:/D ZpZ'r-� <br />FIRE DEPARTMENT <br />Separate I Deferred Submittals Required: <br />[IFIreSprinklers OFIre Alsnn ElOther: <br />Additional Notes: <br />0 This Permit Is Approved by Public Works T <br />See PW Review Woriesheet and associated aflec's f Items <br />®ASepsmWFWPmmitk Requlmd(Permit 8-M9asg/'olI ) <br />AND 14 Is located in this folder <br />❑ Is In a Separate Green Folder grin WlM1Nb Nlderforpumn Nau.nm) <br />❑ Wit be Issued separately lsapemm Green rawer. PW Neued shaaeofalaol <br />❑ Public Works has n0 scope --PW Not Required <br />Fire Dept. Fees: <br />❑RevfeWof As-BMIt Plana -NO FIRE FEE <br />RMlnlmal or No Fire Scope -NO FIRE FEE <br />❑ Review] Inspection Scope -ADD FIRE FEE <br />Approved By. Data: <br />Additional Notes: <br />ELECTRICAL <br />Addlifonel Notes: <br />Approved By: Date: <br />Approved By: <br />UVWA JA <br />Whotildi, Dale: p) <br />2 <br />1OL7i <br />Z12 <br />