4122 COLBY AVE A B 2022-07-20 - Laserfiche WebLink

• Intake & Approval Sheet 111 (FOR PERMIT STAFF ONLY) PERMIT#12�od02M. 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 0 Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments IBIdgITI/Addn/Rem Size (pal O +r2 0 Hold in Planning File Drawer ,Garage/Accessory Struct. Size — Zone G _ Number of Stories 3 Overlay/Agreement C K)14" Basement ❑Yes , Fin/Unfin Nonresidential Use Type of Construction lac- Residential Use 12&Up' )G { (S . Occupancy Group 1 Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: 3 Fire Sprinklers: El Update Existing RI New System ( Not Req'd Planning/Landscape Inspection Required before Final? ii'es DNo Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing New System InNot Req'd School Impact Fee: Total $ CQ 02-0 Reason Fire Alarm Required: Cal ulated: Credit: RCW 64.55 MF worksheet req'd for permit? El Yes No Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes Ad```ditional Notes: VALUATION CALCULATION: Total$ 43 r1 9-44- �Ifd3$) �- Cr+510-2Clu) = . 434,8 44?=. e2) C 2 S) _ g oo Approved By:(A Date: 4. /Zl-, ,2_41j4 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: i❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: 4( zyj� '❑Backflow Prevention for high hazard: 3(dental,medical,animals,mortuary,hospital, Y 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) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ® This Permit is Approved by Public Works Esee PW Review Worksheet and associated attached items Fire Dept. Fees: A Separate PW Permit is Required (Permit#: PW200 4- O ) ❑ Review of As-Built Plans-NO FIRE FEE AND is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(loin with this folder for permit issuance) IS Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:KYb'O( 1 Date:(,. y2-3—,2Q2O ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: /� Date: le[ 4.1 :