220 OLYMPIC BLVD T MOBILE ANTENNA 2023-06-30

Intake & Approval Sheet (FOR PERMIT STAFF ONLY)• PPPERMIT# bL" lOS-OC.A BUILDING PLANNING Intake OK by: Date: Intake OK by:(-7..5 Date: v Intake Comments: Intake Comments: Assign To: s?0,,A, S .C'c\ 'fir shy Use LU��\e �,^e.0 S\o. e CU?s°N,-eft" \' -3 WQ'�'- �Q k d2�.� %cf-ee.s`k, 2 ,k\gr-eA\ ❑ Route to Commercial Building ®Attach to Project No. J V U U� 00 1-- ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments BldglfUAddn/Rem Size ❑Hold in Planning File Drawer Garage/Accessory Struct. Size Zone NCS " 1-- Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use \)N1G� 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 ONot Req'd Planning/Landscape Inspection Required before Final? ►i Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ONot 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? ❑Yes El No Additional Notes: \- VALUATION CALCULATION: Total $ • L-0 45 ksi Sv o\\ \`R .fleck \ j O -c LM\ . 2c'_•V A\ t:7( ceGiAi Ce(� tA l Approved By:� Date: L© ``.ZQA,C1 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval DSite Work or Drainage Proposed Approved By: �!: Date: cif tat Lel ❑Backflow Prevention for high hazard: I (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑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 ❑ 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: WPublic Works has no scope---PW Not Required Additional Notes qfi f f? ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: