6200 23RD DR W TSI SEATS 2022-01-26

Intake &Approval Sheet 110 (FOR PERMIT STAFF ONLY) S PERMIT#?)200 0171 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W Permit ❑ OK to Route to Other Departments BId /TI/ ddn/Rem Size 34' JAS ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size ® Zone Number of Stories / Overlay/Agreement Basementlo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction _ 6 Residential Use Occupancy Group ,8/,�//E/ Proposed No.of Dwelling Units: Occupancy Load z_88 Total No.of Dwelling Units: Fire Sprinklers: pUpdate Existing Chew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee: Type: Amount$ Fire Alarm: ,J,Jpdate Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes Et No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes i❑No Additional Notes: VALUATION CALCULATION: Total$945-j 97X4r0 Approved By: of 0 Date: Lt ! 24 f PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: iPWWorksheetNeededif: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved B Date: /rpZo :OBackflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, !supportive housing) FIRE DEPARTMENT . El Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: El This project also has a separate concurrent PW Review(Green Folder) Fire Sprinklers ElFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: El This Permit is Approved by Public Works 0 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 0 Is in a Separate Green Folder(join with this folder for permit issuance) IS Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: K.15C c4'r Date: y-/y blic Works has no scope---PW Not Required Additional Notes: 0 4-/6 9 t Lozo ELECTRICAL l: bP,A *5, Additional Notes: Approved By: Date: Approved By: Date: