1321 COLBY AVE 3RD FLOOR 2022-01-26

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONL1) 10 PERMIT #f 2�f) I 1-0 1 L BUILDING' Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit BldgiTI/Addn/Rem Size Garage/Accessory 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'[ RCW 64.55 docs required prior to final? ❑Yes ❑ No VALUATION CALCULATION: Total Additional Notes: Approved By: Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑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: ❑ 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: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: PUBLIC'WORKS` Intake OK by: Date: Intake Comments: IPW Worksheet Needed if.• i -0Sys Dev Eval ❑Traffic Mit Eval 0Site Work or Drainage Proposed ' 0 Backfiow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, ;supportive housing) t.............. ...... _...............,........ -...... .,................_........ .............. ........................................... ❑ 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 folderforpermit 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: