20090520160026.pdfREQUEST FOR TEMPORARY OCCUPANCY FORM
Proj ect Name.
Project
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a
Person Requesting Temporary Occupancy - ✓i 1 f SALe�n�
(Note only the property owner or building owner may request "orary occupancy) (Print Name) /2
Today's Date El (el I I e, Date Temporary Occupancy Needed Z
Check the box indicating that the noted items are complete on site. All fire and life -safety
requirements for Building, Fire and Engineering shall be complete in order for Temporary
Occupancy.to be considered. List any specific item that is missing and indicate the date when it
will be provided.
1_All building windows, exterior siding, roofs and exterior doors are
installe omplete.
Missing:
2. CK All required fire rated construction (floor/ceiling, walls & unit separations, etc.)
and structural members (columns, beams, etc.) are complete.
Missing:
3. OZ All required fire protections systems are complete and in full operation, including
fire sprinkler, fire alarm, standpipes, fire and smoke detection, fire suppression, etc.).
Annunciation and/or notification equipment is installed and is operational.
Missing:
4. CZ� All required components of the means of egress system shall be complete and
operable, including but not limited to exit enclosures/corridors, fire rated doors and windows,
door hardware, illuminated exit signage, and emergency lighting, stair handrails, guardrails, etc.
5. l�( Accessible signage, accessible parking, ramps, and directional signage is
installed.
Missing:
6. CK All interior finish materials on floors and walls are complete.
Missing.
7. The number parking spaces on-site striped are including accessible
parking space(s). �3 /0,9
Missing: Tie; D/C�..C01 �— S71 !� i/t� 00 5/zo
ofc
8. ❑ Circle the following. u. Jliti hat are complete storm,water sewer le ca
heat, igh phoire cable, an garbage/recycling .
missing:L' ZC3 u E
9. X Required eros cannectian protection of the potable water system installed for
premise isolation and all required interior fixtures.
Missing;
10. CK Sp fy the unit numbers, tenant spaces or floors requesting- occupancy.
11. ❑ For multifamily or mined use buildings, submit a written statement of how
continued construction and occupant co -existence will be achieved.
12. ❑ 'Attach a site plan showing the following:
• How Fire Department access will be, maintained.
Location of construction worker parking (on street parking shall be regulated
by Parking Enforcement and will be subject to applicable fines).
• Construction material storage.
How safe tenant access will be maintained to the spaces/areas where
temporary occupancy is being requested.
• How required parking will be kept clear of construction worker parking and
material storage.
• How garbage access will be maintained clear and accessible.
• A work schedule detailing completion of the remainder of the project and
estimated date for request for Certificate of Occupancy for the entire building.
13. The State Electrical Inspector has approved service.
Missing:
14. ❑, Elevator service has been approved by the State Inspector.
Missing:
15. ❑ Snohomish County Health District approval has Pecn granted.
Missing: A 5 ri
-16. Plumbing systems are complete.
Missing:
17. C%, Mechanical and HVAC systems are complete.
Missing:
18. 6P,,, Address numbers posted, occupant load signs posted, accessible signage is posted.
Missing: 5 ZC>
19. ❑ For buildings containing more than two units, submit the Building Enclosure
letter required by HB 1848.
20. cW- Attach a work schedule detailing the remaining work on the project and include a
final completion date.