500 SE EVERETT MALL WAY A BASE FILE 2019-09-05

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# Altil 01 OOP `P BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: El Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ 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 C-- \4 Number of Stories Overlay/Agreement _ Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use , 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: RCW 64.55 MF worksheet req'd for permit? ❑Yes El No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total $ \Xt "K KeCQ , -S Approved By: Rp Date: Li.. `s- Zv►\Ck PUBLIC WORKS Intake OK by. T .l Date: 4 /15/2-0.19 Additional Notes: Intake Comments: PW Worksheet Needed if: A lm. 200E v•a,-e's ❑Sys Dev Eval ❑Traffic Mit Eval Mite Work or Drainage Proposed Approved By: '' ''VDate: �jl(lt ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) IRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works El See PW Review Worksheet and associated attached items Fire Dept. Fees: El A Separate PW Permit is Required(Permit#: PW ) O Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder O Minimal or No Fire Scope-NO FIRE FEE El Is in a Separate Green Folder(join with this folder for permit issuance) El Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 4blic Works has no scope---PW Not Required Additional NQ - 7 ' yj____ 11/5/to ELECTRICAL - Additional Notes: Approved By: Date: Approved By: Date: 0_,..11