6707 HARDESON RD UMBRA CUSCINETTI INC 2022-03-23

Intake & Approval Sheet O (FOR PERMIT STAFF ONLY) • PERMIT # M�t�J-01] 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'] 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: .,y 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 Inspec ' n Required before Final? ❑Yes BNo "In Lieu" Fee: Type: Z Amount $ School Impact Fee: tal $ Calculated: Credit: ❑Everett Scho Dist ❑Mukilteo School Dist Additional No s: Approved Date: \I- 6\ PUBLIC WORK$"` Intake OK by: Date: . ......................,....._.....,.,,._......e.., Intake Comments: PW Worksheet Needed if., ']Sys Dev Eval ❑Traffic Mit Eval :]Site Work or Drainage Proposed ]Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, (supportive housing) e...-...„.......,.... _...........................-...-..-.--__..............................,...........-.................... ❑ 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 folderfor 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: