12806 19TH AVE SE BROOKDALE SENIOR LIVING 2019-11-15

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# &W(q (O-' 43 BUILDING PLANNING Intake OK b01 Date: L��0447 Intake OK by: Assign To: Date: Intake Comments. Intake Comments: lee/Art- �v ,0l2 /M. J3 n c <Ari: CAA �r \3 s. ❑ 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/Addr> n Size /CO SF 0 Hold in Planning File Drawer Garage/Accessory Struct. Size s(//A Zone (-_ - k Number of Stories 3 Overlay/Agreement Basement JNo ❑Yes , Fin/Unfin Nonresidential Use / Type of Construction V4 Residential Use ✓ Occupancy Group Lc/4 Z/43 Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑ Update Existing New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: 2 i0At/L.✓'✓elatiC VEX; "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System mot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 2 No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 'INo Additional Notes: VALUATION CALCULATION: Total$ZO Zp $ /,' Approved B Date: N(),\Q, ZQt,Ck PUBLIC WORKS Intake OK by: � Date: rc> (io IV? Additional Notes: Intake Comments: £PW Worksheet Needed if: I 4-k-a---Ci-.a 1. co,it-ur.- DSys Dev Eval ['Traffic Mit Eval ❑Site Work or Drainage Proposed Approved B Date:��0/�/� I❑Backflow Prevention for high hazard: / ;(dental,medical,animals,mortuary,hospital, _supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: DThis project also has a separate concurrent PW Review(Green Folder) Fire Sprinklers ❑fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works LiVeit 4A. dt,C 0p r fo sp,�p✓KLE.t .ors(a4A.6�. ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required(Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder Et Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By: U� n Date: fin— lc'I q L,,��Eblic Works has no scope--- PW Not Required Additional Notes: z________"<,(--,/----i Lia /its I t of ELECTRICAL Vcf Additional Notes: Approved By: Date: Approved By: Date: