5901 23RD DR W PROVIDENCE 2023-05-22

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) fb PERMIT#i622-°S �d35 BUILDING PLANNING Intake OK by: Date: Intake OK by:, k Assign To: '�l.vy,.P . Date: C/?i '/a7i " Intake Comments: Intake Comments: r ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ ute to Historic Reviewer ❑ Make this a"W" Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size 20 54_4'3 -y ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size — Zone L.Z Number of Stories 1 Overlay/Agreement Basement ElNo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction a[- Residential Use Occupancy Group S � S� Proposed No. of Dwelling Units: Occupancy Loa -49 Total No.of Dwelling Units: Fire Sprinklers: Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinkle s Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: Oa Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes J No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ii5No Additional Notes: VALUATION CALCULATION: Total $ 0 co Do,' Approved By: A Date: q/—j/ZZ PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: 3 ❑Sys Dev Eval ❑Traffic Mit Eval DSite Work or Drainage Proposed Approved By: ) �-lg Date: I9/ 2 ❑Backflow Prevention for high hazard: + / _(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) ire Sprinklers Kire 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) g-Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) Approved By:\`. l ,(Ov1/4.)h Date: Cot- -c is; Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: s to 13 I 1-02'4- Approved By: Date: Approved By: Date: