2503 MADISON ST 2023-09-26 - Laserfiche WebLink

• • .. Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT 2i119 r (A0(' BUILDING PLANNING'. Intake OK by: Date: Intake OK by: 0195 Assign To: . Dater•Z - Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building to to Historic Reviewer ❑ Make this a"W"Permit K to Route to Other Departments Bldg/TI/Admyze ,//1 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size A/O Zone V �J Number of Stories 'Z Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction 2-- Residential Used -�� `�V11r J Occupancy Group v'G Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ENot Req'd Planning/Landscape Inspection Required before Final? :Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System. ot Req'd School Impact Fee: Total $ _ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? B,Yes ❑ No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ®Yes El No Additional Notes: VALUATION CALCULATION: Total$ %Z,15a-",60 Approved Byy2 Date: - .272'1 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval s❑Site Work or Drainage Proposed Approved By Date:Ay6y.1.ti ❑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) El 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 0 Is located in this folder Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(loin 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: c{ ,t,y n Date: /f -�j- ,/ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By:' , j Date: 1Visijl1r_./