1402 SE EVERETT MALL WAY A T AND T 2019-09-05

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# v)" 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 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone C'_— Number of Stories Overlay/Agreement Basement El No ❑Yes, Fin/Unfin Nonresidential Use C6re.: 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 re 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 0 No ❑Everett School Dis ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: VALUATION CALCULATION: Total $ /017 Ift. 0 Approved By: ti Date: .1S,Z2 2.0`cl PUBLIC WORKS Intake OK byr—ria Date: 31222 p 19 Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By:A - Date:03/ZZ Z®/q ❑Backflow Prevention for high hazard: A, (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute 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) El Fire Sprinklers ❑Fire Alarm ❑Other. AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) O Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: -ublic Works has no scope---PW No Required Additional Notes 3 122 2a 1 ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: