1701 41ST ST DECIDE MASSAGE 2019-08-08

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1�J--00 t BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size Q:Hold in Planning File Drawer Garage/Accessory Struct. Size Zone C. - V-- Number of Stories Overlay/Agreement Basement El No ❑Yes, Fin/Unfin Nonresidential Use Yetz,elAc` 43A 65 Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yeslo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing El New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo Sc of Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ Approved By: 1L Date: 3 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Tr is Mit Eval ❑Site Work or Dr.• ge Proposed ( 141 Approved By: Date: ❑Backflow Pr:,ention for high hazard: t• (dental,medi :,animals,mortuary,hospital, supportive ousing) FIRE DEPARTMENT ❑Route this folder for PW Review at e - ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate current PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder • ubmitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved .i Public Works 0 See PW Review Wor heet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required(Permit#: PW O Review of As-Built Plans-NO FIRE FEE AND 0 Is loca •d in this folder O Minimal or No Fire Scope-NO FIRE FEE 0 Is i Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Publ. Works has no scope---PW Not Required Additi. al Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: