10821 19TH AVE SE PNW PHYSICAL THERAPY 2019-07-25

Intake &Approval Sheet (FOR PERMIT STAFF ONLI9 PERMIT# r6l%C Z6-4- BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 2.00 SF 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone `6-2VD Number of Stories f Overlay/Agreement Basement No ❑Yes , Fin/Unfin Nonresidential Use rYteb-o1 Type of Construction (IQ Residential Use Occupancy Group B Proposed No. of Dwelling Units: Occupancy Load /5 Total No. of Dwelling Units: Fire Sprinklers: Bupdate Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ErNo Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ®Update Existing ONew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes i1 No DEverett School Dist ❑Mukilteo Sch of Dist. Add'I RCW 64.55 docs required prior to final? /Z,❑Yes �No Additional Notes: 1,(aeriry t'�- cwt — {l0-e 'er L1`.) VALUATION CALCULATION: Total$ 6 • 00 re-xik Q-,�.e, orct florc - tom flrANr- Approved By: \-ktiNp Date: PUBLIC WORKS Intake OK by:x724'-A Date: 9/(.it i& Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval �Ib TsJ Scv[v ❑Site Work or Drainage Proposed pp w ALL- '•�'Ve CA- .wta • ❑Backflow Prevention for high hazard: Approved B Date967// (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer- a Prelim/ .ry • -view Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire No,•s to 'roj Olt-- eam 0 This Permit is Approved by Public Works Date: (i K ._- t. It er Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinkler ❑Ur - :, xisng ONew Syst: 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW Fire Alarm: ■Up.ate Existing ON- ystem 0 Not Req'd AND 0 Is located in this folder Chemical Sup: ■Up. - ing •New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ 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: Date: