1520 W CASINO RD BLDG D 2021-12-20

Intake & Approval Sheet � (FOR PERMIT STAFF ONLI � PERMIT # D�Z - P-;3 . 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 GarageLAccessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: []Update Existing ❑New System ❑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 $90 02,5-Oc- i rfyc, F� Additional Notes: r. Approved BY j Date: 0 G1Z j �?,0Z-0 FIRE DEPARTMENT Separate / Deferred Submittals Required: El Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING. Intake OK by: Assign To: Date: Intake Comments: oe vw &r 1Lh-C:c r� f r, a4 r�s ec_6- ❑I At ach 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 n o )�', - -t- rn t L Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ZNo "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: rI PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Worksheet Needed ff.• 'Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: ;(dental, medical, animals, mortuary, hospital, :supportive housing) e......._.........._..................... .... —...... ........ ........ —............. —... _._............ ..... ..._.. ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑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 (join with this folderfor permit issuance) ❑ Will be issued separately (separate Green Folder, PW issued ahead of Bldg) ® Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: