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Intake & Approval Sheet - (FOR PERMIT STAFF ONLY) PERMIT# c grog, <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: (`I (2. X <br /> l t <br /> Intake Comments: Intake Comments: Assign To: mut <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit 0 OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone c- `R <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use c 0010 \ <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 No" <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ <br /> Fire Alarm: El Update Existing ❑New System El Not Req'd School Impact Fee: Tot. <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Ever- chool Dist ❑Mukilteo School Dist. <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No A.. ional Notes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By' - Date: g -I ZQ`g' <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Nee--d if.• <br /> ❑Sys Dev Ev. ❑Traffic Mit Eval <br /> ❑Site Wo,'or Drainage Proposed <br /> "� ❑Baa''ow Prevention for high hazard: <br /> Approved By / ysi— Date: atibezel� (de .ica, - imals,mortuary,hospital, <br /> �[Y` /,/=.ortive housing) <br /> FIRE DEPARTMENT El Route this folder for PW Revie +(t end ---PWRevi,w orksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a se..r.te concurrent PW Revi,•w Green Folder) <br /> ❑RoutetoFireDrawer---FirePreliminaryReviewNotice AND ❑Create Green Fol er •Submiiously Deferred <br /> ❑Sending Fire Notes to Project Team 0 This Permit is App .ved • Public ' r1 <br /> Date: (OK to Route to Other Departments) 0 See PW Revie• orksh-et andd\ssociated att ed items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate Permit i- Required(Permit 'W <br /> Fire Alarm: ❑Update Existing New System 0 Not Req'd AND 0 I ocated in this fo •er <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd ■ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ■ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: Date: 0 *ublic Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> (27z, <br />