1525 75TH ST SW CASCADE COFFEE 2021-12-28

Intake & Approval Sheet 10 (FOR PERMIT STAFF ONLV) 0 PERMIT #M Z. � o4 — ad -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 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'I 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 []FireAlarm ❑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: Z Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer to Route to Other Departments 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: . ................. ................... ......... ........ ...... ................ W,........... ..... ............ ......... ...-_, Intake Comments: PW Worksheet Needed if. i T1Sys Dev Eval ❑Traffic Mit Eval 3 []Site Work or Drainage Proposed s ❑Backflow Prevention for high hazard: (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) 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 folder for 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: