2930 MAPLE ST KAISER PERMANENTE 2020-12-31

• Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#m2O 2 0 BUILDING �,p PLANNING Intake OK by: Date: Intake OK by:�/".U-� Assign To: Date: Z)J'0l2o Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer CI Make this a"W"Permit K to Route to Other Departments e Bld /TI/Addn/Rm Size L_! Hold in PlanningFile Drawer 8 , Garage/Accessory Struct. Size _ Zone 044 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: ❑Update Existing El New System El Not Req'd Plan ing/Landscape Inspection Required befo Final? ❑Yeso Reason Sprinklers Required: "In Lieu" e: Amount$ Fire Alarm: ❑Update Existing New System ❑Not Req'd School Impact Fee: Reason Fire Alarm Required: Calculated: edit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No El Eve chool Dist ❑Mukilteo Scho 'st Add'I RCW 64.55 docs required prior to final? ❑Yes El No A ditional Notes: Ali t/I (cY {'N e�ha/�r` I. N VALUATION CALCULATION: Total Approved By: ( Date: .7 /(o/z PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: ipw Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: 1 Date: 2 I O/ � OBackflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred Additional Notes: ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required(Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ 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,P ' ued ahead of Bldg) Approved By: Date: P blic Works has no scope---PW Not Required ty ' ..Itional Notes: ELECTRICAL `��` Additional Notes: Approved By: Date: Approved By: Date: