510 MADISON ST 2022-02-15 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT# 2010 -iQ 35 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size (9� N-{ 1.- 0 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 t=7 Residential Use Occupancy Group Proposed No. of Dwel'ng Units: Occupancy Load Total No. of Dwelli • Units: Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Planning/Lands ape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu" Fee: 'ype: Amount$ Fire Alarm: ❑Update Existing ONew System Not Req'd School Imp. t Fee: Total $ Reason Fire Alarm Required: Calculate': Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes II;77II No ❑Ever-tt School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ts.l No Additional Notes: VALUATION CALCULATION: Total Z ce—\)�2.UJ � C lr j �O Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval OSite Work or Drainage Proposed Approved By: If? Date: ) /�_/ I ❑Backflow Prevention for high hazard: 6 I (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑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) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑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 0 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: Date: ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: