902 N BROADWAY REFINED COFFEE 2023-02-06

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) • PERMIT#( CI k 2 `ck9 BUILDING PLANNING AIntake OK by: •/Z Date: /z,/z6/,' Intake OK by: Assign Toi N tZ Date: `2/I7/I 9 _ Intake Comments: Intake Comments: \Jen ,V 1 GtrtalS a ait Route to 6efAaze vial Building_ ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Ma this a"W"Permit ciOK to Route to Other Departments BI g/T.ddn/Rem Size / fjc? ,,jiC El Hold in Planning File Drawer Garage/Accessory Struct. Size A/Ad Zone b/V' V Number of Stories / Overlay/Agreement Carf lraC+- ' 2SVI,-e_ Basement Olo ❑Yes , Fin/Unfin Nonresidential Use (Nee ,S Type of Construction t/J3 Residential Use Occupancy Group . a Proposed No. of Dwelling Units: Occupancy Load SC Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System , Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: E'11pdate Existing ❑New System ❑Not Req'd of Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes gt No DEve c ool Dist School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes P.No Additional Notes: VALUATION CALCULATION: Total$ pa°0•°49 Approved By: Date:211 zl2a PUBLIC WORKS / Intake OK by: -T'r1 Date: 12-In1 1 I Q Additional Notes: Intake Comments: PW Worksheet Needed if.: rF£e_ S iN Ef,s• ❑Sys Dev Eval ❑Traffic Mit Eval ILA.w.F.-4 5•vpc_•F. '❑Site Work or Drainage Proposed Approved B �,.. Date:0.47/7��p� V'(`''` v� t cLN`;�''s ❑Backflow Prevention for high hazard: :(dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE DEPARTMENT 11gRoute 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 DOther: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: his Permit is Approved by Public Works ee PW Review Worksheet and associated attached items Fire Dept. Fees: L_l 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) El-Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: K Orr) �,ri Date: /a2-5/—/ ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: D 8(2_//ZZ,, 4