1122 75TH ST SW SNO CO PUD 2023-08-08

i Intake & Approval Sheet O(FOR PEhMIT STAFF ONLV) '*PERMIT #T120q C% 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 1J- "t Fire Sprinklers: JnUpdate E:asting ❑New System []Net Req'd Reason Sprinklers Required: Fire Alarm: MUpdateEx1.ting0NewSy.tern ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes MY No Add'I RCW 64.55 does required prior to final? ❑Yes No VALUATION CALCULATION: Total $ \e50 000 Additional Notes: Approved By: Date: 2� FIRE DEPARTMENT Separate / Deferred Submittals Required: 15Fire Sprinklers lEgFire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑,,,Minimal or No Fire Scope - NO FIRE FEE eview / Inspection Scope - ADD FIRE FEE Approved By: Date: S 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 be a Final? ❑Yes []No "In Lieu" Fee: Type, Amount $ School Impact Fee: Total $ - Calculated: Credit: ❑Everett Sc ist ❑Mukilteo School Dist Additio Notes: Approved Date: PUBLIC WORKS Intake OK by:. Date: :.... ..... ..,................................ ... ......... -.... _..................................... ....... Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eva] ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backf]ow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, ,supportive housing) El 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 Qoin with this folder for permit issuance) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) Public Works has no scope --- PW Not Required Additional Notes: Date: 05+ 2I /ZV z