1505 112TH ST SW UNITED METHODIST CHURCH 2023-12-27

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # 1� 2-0 12'DD J BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size �f 7 Garage/Accessory Struct. Size Number of Stories Basement Mo ❑Yes , Fin / Unfin Type of Construction i J —,5 Occupancy Group A — 3 Occupancy Load 73 Fire Sprinklers: El Update Existing ❑New System Not Req'd Reason Sprinklers Required: Fire Alarm: []Update Existing Wew System El Not Req'd Reason Fire Alarm Required ( a c RCW 64.55 MF worksheet req'd for permit? []Yes 4N No Add'I RCW 64.55 dots required prior to final? ❑Yes 15INo VALUATION CALCULATION: Total $ � 19 Additional Notes: Approved By: lj-1� Date:` ,2 / FIRE DEPARTMENT Separate_ / Jeferred Submittals Required: �KI IRklers ire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE a Review / Inspection Scope - ADD FIRE FEE Approved By: Date: >a-1 ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: iffl Q �,/ Date: Intake Comments: I _I b i� i lu�rn ttSS uG r�ewtevt-f- s�b►�+Icd . DeSc� h JECAttach to Project No. ❑ Route to Historic Reviewer El OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone ; - I Vvt U v Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: l yu"Wu S Gt ,D (Na ( W '�GS��J� ►-X kJl t,�,�! a� ►;cGt �l01-1 U �'\l►-016. Approved By: Date. PUBLIC WORKS Intake OK by: Date: ................. ........................ ,,,,..............,,,.,..,............ ....................... ...........,,,,...,,...,,,.,.,............ Intake Comments: PW Worksheet Needed if. ❑Sys Dev Eval ❑Traffic Mit Eval i 1 []Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: '(dental, medical, animals, mortuary, hospital, ,supportive housing) i......................................................................................................................................................... El Route this folder for PW Review at end --- PW Review Worksheef ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder Qoin with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: