2930 MAPLE ST KAISER PERMANENTE 2025-05-12

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # MI00 ✓ /0800 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 Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: El Update Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: El Update Existing El New System El Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No VALUATION CALCULATION: Total $ Additional Notes: Approved By: Date: �v 202A FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Iyw &4A).— Fire 134t. Fees: Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE GT-Review / Inspection Scope - ADD FIRE FEE pproved By: Date: EL ICA Additional Notes: Approved By: Date: PLANNING Intake O by: ,, sign To: Date: Intake Co ments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone 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: El Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: PUBLIC WORKS Intake OK by:Date: ................. ......._...._.......... ............. Intake Comments: ;PW Worksheet Needed if., []Sys Dev Eval ❑Traffic Mlt Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: ;(dental, medical, animals, mortuary, hospital, !supportive housing) ......................................................._........................... El Route this folder for PW Review at end ---p..... W Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) ND ❑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 0oin with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scop -- PW Not Required Additional Notes: Approved By: Date: