620 112TH ST SE SPACE 213 2023-10-16

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# -02 104" 051 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 0 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 1 ) IL' Number of Stories I Overlay/Agreement Basement ONo ❑Yes, Fin 1 Unfin Nonresidential Use Tyke of Construction S11-C- Residential Use (Y)cuti o—. i 4onriL Occupancy Group '- Proposed No.of Dwelling Units: Occupancy Load kYf.(. Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing El New System Mot Req'd Planning/Landscape Inspection Required before Final? DYes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System In Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: . Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes LNo ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: VALUATION CALCULATION: Total$ te),tbc)d .'p'l 0.i_1daa '-3 / 17 /7 Approved By: Date: PUBLIC WORKS Intake OK by: Date: 061 0142027j Additional Notes: Intake Comments: IPW Worksheet Needed if: IDSys Dev Eval ❑Traffic Mit Eval i®Site Work or Drainage Proposed Approved By: p.$)'1 Date: /v4/zoz3 �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) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 7 Additional Notes: VI 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: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By:�1 /II� Date:001 0g 12,02t