906 SE EVERETT MALL WAY POLYWORKS 2019-09-05

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#Q7(9.0 -0( 0 BUILDING PLANNING yFf\ Y, Date: Oi /,zo/9 Intake OK by: Date: Intake OK b e 1, 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 1322- 0 Hold in Planning File Drawer Garage/Accessory Struct. Size _ Zone V jf2-- Number of Stories CO Overlay/Agreement ��j Basement ONo ❑Yes , Fin/Unfin Nonresidential Use (,J"r` L, Type of Construction 2E. - I\ Residential Use Occupancy Group Proposed No. of Dwelling Units: /../ Occupancy Load 13 Total No. of Dwelling Units: Fire Sprinklers: El Update Existing El New System ,Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes gNo 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: C : RCW 64.55 MF worksheet req'd for permit? ❑Yes 1 No DEverett School Dist ❑ ilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes JENo Additional Notes: Y1 1n`,� = ,� no VALUATION CALCULATION: Total$ �$ o I S -eAlee`te- ri or ail ra.t-eek i5 powil Approved By: y... .\\.(„, Date: 1...i 0- lei PUBLIC WORKS Intake OK by—1 LA Date: I I to I l a Additional Notes: Intake Comments: PW Worksheet Needed if: I ,N--ceg-.o -r t 0,.M_" ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: 1/ZSMMo 'pvrt S c�E. ❑Backflow Prevention for high hazard: 1, (dental,medical,animals,mortuary,hospital, supportive housing) 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) El 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 Zi Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ONew System ,® Not Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existing�7❑New System ® Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: 0O I Stec-fho ,-- j ,e rJ -L ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: GJCraic, Date: I - 15"101 GLV Public Works has no scope---PW Not Required Additional Notes: �*.,_..1 J ELECTRICAL i Y t O i i ct Additional Notes: Approved By: Date: Approved By: Date: