2825 COLBY AVE COLBY CENTER 2026-01-02

intake &Approval Sheet (FOR PERMIT STAFF ONL�q PERMIT# A/�3o S '021 BUILDING _ANNiNG intake OK by: Date: intake OK by: _ Assign To:J2SS Date: 5 12 23 Intake Comments: Intake Comments: Zone M U Overlay/Agreement h4eA-ro,park;.,g Area A,�?l eefi ❑ Route to Commercial Building Nonresidential Use Mi ❑ Route to Residential Building Residential Use ki/A ❑ Make this a"W"Permit Proposed No.of Dwelling Units: Nip, Bidg/TI/Addn/Rem Size Total No,of Dwelling Units: MIA Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? [ Yes QQ No Number of Stories "in Lieu"Fee:Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 11112022: Fire Sprinklers: El Update Existing []New System ❑Not Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): -------------------------------------------------------------- ------------ Fire Alarm: Update Existing eq'd New System Not R Permit Technician Use Only:Apply Phase-in Credit Per EMC19.53----.20-- 0 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 dots required prior to final? ❑Yes []No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: Approved By: Date:5/1 Z Z 3 PUBLIC WORKS Additional Notes: intake OK by: Date: ------=----------------------------------- Intake Comments: IPWWorksheet Needed if ❑Sys Dev Eval(Util/SW) ❑Traffic Mit Eval Approved By: Date: '❑]Site Work/Drainage DAddressLetter ;ElBackflow Prevention for high hazard: FIRE DEPARTMENT ;(dental,medical,animals,mortuary,hospital, ;supportive housing) .----------------------------------------- Separate i Deferred Submittals Required: ❑Route this folder for PW Review at end —PWReview Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND []Create Green Folder ❑Submitted Previously ❑Deferred ❑This Permit is Approved by Public Works Fire Dept.Fees: ❑ See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Pen-nit#i:,PW ) ❑Minimal or No Fire Scope-NO FIRE FEE AND ❑ is located in this folder ❑ Review/inspection Scope-ADD FIRE FEE ❑ is in a Separate Green Folder Goin with thisfolderfor permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑Public Works has no scope—PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: