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Intake & Approval Sheet (FOR PERMIT STAFF ONLI9 PERMIT# <br /> BUILDING PLANNING ?? <br /> Intake OK by: Date: Intake OK by: ", Assign To: V Date: J <br /> Intake Comments: Intake Comments: <br /> see W 1-J 02- CW 1'163_6 16- <br /> ❑ Route to Commercial Building ❑ Attach to Project No. <br /> ❑ Route to Residential Building ❑ oute to Historic Reviewer <br /> ❑ Make this a"W"Permit OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size — Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No Yes, Fin/ n n Nonresidential Use <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: []Update Existing ❑New System ®Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Wo <br /> Reason Sprinklers Required: "I Lieu"- e:Type: Amount <br /> Fire Alarm: ❑Update Existing ❑New System ®Not Req'd Sh/verett <br /> Imp t Fee: Total $ <br /> Reason Fire Alarm Required: C cted: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes No Sch olgist M kilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ®No Additional Notes: <br /> VALUATION CALCULATION: Total$ 144 , to00 <br /> 1 +41 ODD <br /> Approved By Date: P �Q <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PIN Worksheet Needed if. ^� <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> `jJ <br /> ❑Backflow Prevention for high hazard: <br /> [Approved By: Date: (� ;02A <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 /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred <br /> Additional Notes: This Permit is Approved by Public Works <br /> M'See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit M 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:. COL*"O Date:jb-90 O ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date:ld ` -� <br />