620 112TH ST SE SPACE 330 2023-08-01

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) • PERMIT#C2Od II C 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 Fa-3 Number of Stories Overlay/Agreement 5P) .r-Avn )9-719 Basement . No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction .-11.4._ Residential Use ftS10) Occupancy Group P“- Proposed No.of Dwelling Units: Occupancy LoadC- Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System Eliot Req'd Planning/Landscape Inspection Required before Final? ❑Yes I o Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System Mot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? oyes Er No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes allo Additional Notes: g' O\Q, hcr.ei C YVbP' 4-0031,0,4: VALUATION CALCULATION: Total$ 2-0/O0(� I�L11d�� O✓1 �p+ 3?j� �j� Approved By: �� Date: 9 9 ��2U PUBLIC WOii KS �p Intake OK by: Date: ______ __. ..... Additional Notes: Intake Comments: PW Wksheet Needed If: ❑Sysev Eval ❑Traffic Mit Eval Siteork or Drainage Proposed ❑Baow Prevention for high hazard: Approved By: �� Date: t-( '?lf Zp23 (dentaledical,animals,mortuary,hospital,suppo 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 ❑ 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: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: **AA Date: ,5- 0 `�t