1330 COLBY AVE IRG PHYSICAL THERAPY 2022-02-14

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) 11 PERMIT# &(la — 004 BUILDING PLANNING Intake OK by: Date: Intake OK by:#7 Assign To: N.. Date:IQ/ /101 Intake Comments: Intake Comments: C ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ R ute to Historic Reviewer ❑ Make this a"W"Permit OK to Route to Other Departments Bldg/TI/Addn/Rem Size 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 El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El 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 Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? Oyes ❑No Additional Notes: ✓I e-CQ(�"Ojil • VALUATION CALCULATION: Total$ 1�' Approved By: I/"Y Date: fO/M/ PUBLIC WORKS' Intake OK by: Date: Additional Notes: Intake Comments: 'PW Worksheet Needed if: i °Sys Dev Eval °Traffic Mit Eval i°Site Work or Drainage Proposed A roved B Date: ;OBackflow Prevention for high hazard: pp y � ( � y �� (dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE DEPARTMENT DRoute 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) El Fire Sprinklers OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: El This Permit is Approved by Public Works ', ❑ 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: