10200 19TH AVE SE COSTCO HEARING CENTER 2022-01-21

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) III PERMIT# , l` l -U\ 2_. BUILDING PLANNING Intake OK by: �ilP Date: d ( Intake OK by: Assign To: Date: Intake Comment t Intake Comments: Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone 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: El Update Existing El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? DYes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑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? ❑Yes ❑ No ❑Eve rett School Dist ❑Mukilteo School Dist Add'i RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: lmi rhci 61- ,ideyy VALUATION CALCULATION: Total$ Approved By:aiff Date: q. so- )j PUBLIC WORKS Intake OK by: Date: Additional Notes: t-i- �N '4-2 Ctoy, Intake Comments: PWWorksheetNeededif: OSys Dev Eval ❑Traffic Mit Eval DSite Work or Drainage Proposed Approved By: Date: =0Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, H 'supportive housing) FIRE DEPARTMENT El Route 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 ❑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 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: