2817 MEDORA WAY 2023-12-08 - Laserfiche WebLink

• • R Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# V 2-1`O - O e V BUILDING 9y PLANNING Intake OK by: )) `-le- Date: Cf/2Z Intake OK Assign To: �+l Date: \, 9 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/Add em�Size 2-( 6i SF ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories ( Overlay/Agreement Basement ❑No , Yes AD Unfin Nonresidential Use -F-a, Type of Construction Residential Use Occupancy Group ` Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: ©A-Z_ Fire Sprinklers: ❑Update Existing ONew System jiNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ONo Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing El 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 III No El School Dist ❑Mukilte chool Dist Add'I RCW 64.55 docs required prior to final? ❑Yes Es1No Additional Notes: VALUATION CALCULATION: Total $ /0/ 000 Approved Date: S. \-' ts212'L. PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed Approved By: i .- Date: 37j/2.02_Z.-- 1OBackflow 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 OFire Alarm ❑Other: ,A�,ND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: FSI.This Permit is Approved by Public Works E_See PW Review Worksheet and associated attached items Nift Fire Dept. Fees: A Separate PW Permit is Required (Permit#: PW 63 -'Oat ) ❑ Review of As-Built Plans- NO FIRE FEE AND .Is located in this folder O Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) . rH Approved By: Date: II Public Works has no scope---PW Not Required Additional Notes: �."I"'f �� ELECTRICAL f �' ' r q t 't/9f/un" red Additional Notes: _II (t,,iWh ) : - j Approved By: Date: Approved By: 9 [late: I/II IIIIM ogR 212-