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3 Intake & Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# c" ) b 4)4 <br /> BUILDING. PLANNING <br /> Intake OK by: Date: 7 )yie) Intake OK by: W Date: q - 1-)( <br /> IntakeYComments: Intake Comments: <br /> 7 L ger"-Assign To: •t .......... <br /> 'g eliZ ei l T k IT F.EC?'D '�eDet iL.-1-,s3 1^''r�Cei Soe5Y1't TV 4E._ t.._ -- t!1 <br /> .-.1 NRC ' .. 4-4 F4-E t A.pr--r- COY a I N <br /> ❑ Route to Comm- ial Building 0 Attach to Project No. <br /> ❑ Route to Residenti. :uilding 0 Route to Historic Reviewer <br /> ❑ Make this a"W" Per AOK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer <br /> Garage/Accessory Struct. Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement 0 , ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No. of Dwell. . Units: <br /> Occupancy Load _ Total No. of Dwelli nits: <br /> Fire Sprinklers: ❑Update Existing ❑New Syst: i ❑Not Req'd Planning/Land 1 pe Inspection Required before Final? ❑Yes.,ENo <br /> Reason Sprinklers Required: "In Lieu" Fee• pe: Amount$ <br /> Fire Alarm: ❑Update Existing ❑New System 6,1 Not Req'd School Imr',ct Fee: Total $ <br /> Reason Fire Alarm Required: Calcul. .: Cr i : <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 1 o DE rett School Dist ❑M 'teo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes 0 Ay tional Notes: <br /> VALUATION CALCULATION: Total$ <br /> ,\roved By: Date: <br /> PUBLIC WORKS <br /> Intake •�'\by:1.J Date: 9/17 1 16 <br /> Additional otes: Intake Co `'..nts: PW Worksheet Needed if: <br /> vrif61Atj Tzc7v.c , F,�E p,�9 ❑Sys Dev Eval ❑Traffic Mit Eval <br /> ��//�� '' 44JJ —,cil-A«k�, .44.,c.-.Q ❑Site Work or Drainage Proposed <br /> Approved By: Date: ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTME Woute this folder for PW ,iew at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load' R,New Commercial) ❑This project also has a sepa concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer---Fire Pr: mary Review Notice AND ❑Create Green Folder 0 , itted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project -am 0 This Permit is Approved by Public s <br /> Date: (OK t. 'oute to Other Departments) 0 See PW Review Worksheet and asso -d attached items <br /> Fire Sprinklers: ❑Update E .ting ❑New System Not Req'd 0 A Separate PW Permit is Required (Perm ..PW ) <br /> Fire Alarm: ❑Updat= xisting ❑New System, Not Req'd AND 0 Is located in this folder <br /> Chemical Sup: ❑Upd. - Existing ❑New System ,L^h Not Req'd 0 Is in a Separate Green Folder(join with this . for permit issuance) <br /> Additional Notes: pie $ 4.-Ao)z Ag,y oLJ e fpe — 0 Will be issued separately(Separate Green Fold: s issued ahead of Bldg) <br /> Approved By: °PTIGO17'' Date: 9/0g 0 Public Works has no scope---PW Not Required <br /> rl/iA- Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br /> Vdi <br />