2939 COLBY AVE EVERETT MUSEUM 2023-09-26

Intake & Approval Sheet . (F0 ' f'1E- 11111T STAFF ONLY) PERMIT# 1.i„ . ' 2 O t BUILDING f PLANNING Intake OK by: Date: f� (q _. u Intake OK by: ' ' ' ___ Date: 2 - et)._ Il Intake Comments. Intake Comments: Assign To: }La Pc--,/ ___ _.;g1 1511244 -4SS - 6: ❑ Route to Commercial Building ElAttach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size cold in Planning File Drawer Garage/Accessory Struct. Size, Zone 014 Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use G. ,4►2,1-" .)- eur \ Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: DUpdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 531No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: DUpdate Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cred. : RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No El Everett School Dist ❑Mukilt School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: R1-05 �J✓aGlc- ..A. (OOF' ext5� VALUATION CALCULATION: Total$ ,A Sci "- 0'6.`1s; gcos 5\ fl AoA-ir avtd .�� s'nr�1 kr W bat I l� cony'+.-n, � exl?-� d/ Approved By: (\ Date: ?, -I q PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: ?j 1 Backflow Prevention for high hazard: I J ❑(dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ID Route to Fire Drawer---Fire Preliminary Review Notice AND DCreate Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team ❑ This Permit is Approved by Public Works Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items Fire Sprinklers: DUpdate Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: DUpdate Existing ❑New System ❑ Not Req'd AND ❑ Is located in this folder Chemical Sup: DUpdate Existing ❑New System ❑ Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ ADD FIRE FEE ❑ NO FIRE FEE ❑ Public Works has no scope--- PW Not Required Approved By: Date: Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: