1706 BROADWAY PEDIATRIC CRITICAL CARE HOUSE 2019-10-31

Intake &Approval Sheet (FOR PERMIT STAFF ONLYPERMIT# -' t%\2-00q BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone .24-4 0 Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: DUpdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑YesNo Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: El Update Existing ONew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? DYes 0 No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: fV\ ykka .z.y f7 (€4— ':L�10 VALUATION CALCULATION: Total$ �- `22.- 0tQ��J16` It) �i r W� /K� �' '`ai Cry 1\)E) wail S `f Approved By: Date: 1 2,,,,,--10-1‹,‘ HCIBLIC WORKS Intake OK by:iNI Date: 12 I to 12-6/S Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval -1� ..p4.4 Scot'F• ❑Site Work or Drainage Proposed I Approved By: Date: ��(UrI ❑Backflow Prevention for high hazard: I (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) DRoute to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ODeferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: DUpdate Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: DUpdate Existing ❑New System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: DUpdate Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: �� ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) El Approved By: Date: f�Public Works has no scope--- PW Not Required Additional Notes: r . ELECTRICAL ,IM it'20 is Additional Notes: Approved By: Date: Approved By: Date: (..... .7)