2722 COLBY AVE UMPQUA BANK 2019-08-07

Intake & Approved S ac et (FOR PERMIT NAPE ONLY) PERMIT# '9102"COG BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer 0 Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories 'Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use \w,d\C;'\C\ \\4\S�� , VOA Type of Construction R—estdentral_tfse Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: ROW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? Dyes ❑No Additional Notes: VALUATION CALCULATION: Total $ Approved By:("" Date: . \�j 2 C1\Ci pp c '� 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 r _ ❑Backflow Prevention for high hazard: Approved By: Date: 7 ' (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT DRoute 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) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW Fire Alarm: DUpdate Existing ❑New System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ ADD FIRE FEE 0 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: �9 l/ 1