2403 W CASINO RD ZIPLY FIBER 2021-12-16

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# J BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Re tred before Final? ❑Yes LIZ1No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Di ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? Yes No Additional Notes: VALUATION CALCULATION: Total$ Approved Date: yr_ PUBLIC WORKS Intake OK by: Date: Additional Notes: Pt�'��/ Intake Comments: ?PW Worksheet Needed i �p 'D RFRt f. NI? 'Av'Dt n ova- l�na�rirA0.�i b,oD¢�o ❑Sys Dev Eval ❑Traffic Mit Eval 12/i -/ i'° =❑Site Work or Drainage Proposed Approved By: Date: 111Backflow Prevention for high hazard: :(dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT 0 Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) OFire Sprinklers OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: