3915 COLBY AVE 2023-02-07 - Laserfiche WebLink

Intake &Approval Sheet 110 (FOR PERMIT STAFF ONLY) • PERMIT#r r `Z- OS ©c 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 ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct..Size Zone /—al C Number of Stories Overlay/Agreement A. 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 Required before Final? ❑Yes IWo Reason Sprinklers Required: "In Lieu"Fee:Type: A t$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr dit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Muki eo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: i eze,.__ oN,} Go* ybl' VALUATION CALCULATION: Total I� G�G�.49 �G i 5" cc- - (S L'"41--- Approved By: it• 1) Date: b qcb� �� PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: =PW Worksheet Needed if: IDSys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved B ,� ,�„ Date:o6 D y, =�Backflow Prevention for high hazard: :(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) DFire Sprinklers ❑Fire Alarm ❑Other: AND El Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works .... - ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: 0 A Separate PW Permit is Required(Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder _No r•_ _ n____ i r. ❑ Minimal or NNu Fire Scope-NO FIRE FEE 'n' is in r a oeparare 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: /Z-----