1323 BROADWAY CM HEATING 2023-04-11

Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLY • PERMIT # 92 (0 3 - O( ] BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit 21rj Bldg/TI/Addn/Rem Size i✓ — %'e + !i Garage/Accessory Struct. Size Number of Stories Basement []No TSJYes , Fi2SLULnfin Type of Construction $% Occupancy Group ,g S Occupancy Load Fire Sprinklers: El Update Existing ❑New System [2Not Req'd Reason Sprinklers Required: Fire Alarm: El Update Existing El New System ENot Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes IMNo �-^p Add'I RCW 64.55 docs required prior to final? ❑Yes lo VALUATION CALCULATION: Total $ Additional Notes: Approved Date:e_l �.r' 1r FIRE DEPARTMENT Separate / Deferred Submittals Required: El Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE inimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: %Z Intake Comments: ❑ Attach to Project No. ❑ oute to Historic Reviewer OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use KT�C Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: El Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: TY Wbate: . PUBLIC WORKS Intake OK by: Date: ................................................................................................................................................... Intake Comments: PIN Worksheet Needed if. ❑Sys Dev Eval ❑Traffic Mit Eval i❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, 'supportive housing) i............................................................................................................................................................. ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred This Permit is Approved by Public Works See PW Review Worksheet and associated attached items--Ot �d4 XA Separate PW Permit is Required (Permit #: PW,1Jn--039 AND FfIs located in this folder ❑ Is in a Separate Green Folder (Join with this folderforpermit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: i �Z�