1800 41ST ST ZIPLY FIBER 2021-12-17

Intake • • to a &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT #� 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 Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing El New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing El 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 $ Additional Notes: Isar Rrx:(A)iRe? REF-IM, cam• WV r:�D�T o�1au. MOVMI J�, L QDHr11a ? rz(D roD ,� J I II 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 Re fired before Final? []Yes ONo "In Lieu" Fee: Type: Amount $ School Impact Fee: Total Calculated: Credit: []Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved B Date: �'Z PUBLIC WORKS Intake OK by: .Date: ............................................................................................................................................................. Intake Comments: PW Worksheet Needed if.• []Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: i(dental, medical, animals, mortuary, hospital, ;supportive housing) :.. ................ ❑ Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AN ❑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 (ioin with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: AAA Date: