2828 COLBY AVE KIMLEY HORN 2025-04-16

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT # S ZZ 01-0 C 0 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 SI zA& 41" Garage/Accessory Struct. Size -- Number of Stories Basement ❑No KYes, Fin / Unfin Type of Construction_ ' Occupancy Group Occupancy Load ?55 Fire Sprinklers: M Update Existing ❑ New System Mot Req'd Reason Sprinkles Required: Fire Alarm: IM Update Existing []New System El Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes P9 No Add'I RCW 64.55 does required prior to final? ❑Yes 29 No VALUATION CALCULATION: Total $ 1r�s3 ed Additional Notes: Approved By: Date: jd p FIRE DEPARTMENT Separate / Deferred Submittals Required: Fire Sprinklers 2FIre Alarm ❑Other: -r• 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 Inspection Required before Final? []Yes o "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ZpMukilteo School Dist T141 Additional Notes: 0c) Approved By: Date: 7T4, 1, Z PUBLIC WORKS Intake OK by: Date: Intake Comments: =PWWorksheetNeededif, 11Y 1111111111111111Y.,,,,,,.,...," ❑Sys Dev Eval ❑Traffic Mit Eval El Site Work or Drainage Proposed DBackflow Prevention for high hazard: Wental, medical, animals, mortuary, hospital, ;supportive housing) ❑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) TROPublic Works has no scope --- PW Not Required Additional Notes: Approved By: Date: ( �� �v