3726 BROADWAY CONCENTRA URGENT CARE 2025-04-24

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 07%20(0 g Z— BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: AXE Date:1/7/ZOZZ 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 B1.�; ;ddn/Rem Size 7778 Yf� ElHold in Planning File Drawer Garage/Accessory� Struct. Size Zone 1►Iv Number of Stories 3 Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use ( lin 1L Type of Construction .1L-/S Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: Pr 1pdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ' 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 in No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Des No Additional Notes: VALUATION CALCULATION: Total $ )7 S2 00 Approved By: Mc Date: U/2.(//2iZ� PUBLIC WORKS 1r ll Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval DTraffic Mit Eval !❑Site Work or Drainage Proposed Approved By !� l Date: Q7 7l 7/JZZ !❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, !supportive housing) FIRE DEPARTMENT El 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) Tire Sprinklers Fire Alarm El 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 ❑ 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:\<,e(,j,n Date: 9 2- ,, ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: