12906 19TH AVE SE JOINT CHIROPRACTIC 2023-02-06

fUj i SiTTX S CAA'iss- Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# B2 2°3_ 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 ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size "— Zone Number of Stories i Overlay/Agreement Basement ONo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction P' Residential Use Occupancy Group °Ej Proposed No.of Dwelling Units: Occupancy Load I Q Total No.of Dwelling Units: Fire Sprinklers: /1 Update Existing El New System Not Req'd Planning/Landscape Inspection Required before Final? Oyes to Reason Sprinkler Required: "In Lieu"Fee:Type: Amount$ J/ Fire Alarm: 0Update 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 I No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes tgNo Additional Notes: VALUATION CALCULATION: Total$ 12.OtJO Approved By: t A 0 Date: (0.,2-AD yV1. -UBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: 1PWWorksheetNeededif: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: ALT Date• `` `❑ ackflow Prevention for high hazard: I (dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE DEPARTMENT DRoute 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 ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ 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: ,0-2:26,4/0 Date: 6 1Public Works has no scope PW Not Required Additional Notes: ELECTRICAL/PLUMBING 1La neVpet ie Additional Notes: y�/11U4fl,c. tAte/11/491/4..i o ti l - i 11019 Approved By: Date: Approved By: U Date: