505 SE EVERETT MALL WAY UBREAKIFIX 2021-02-22

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# JO °02-- BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. O 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 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 ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes,No 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 ❑ No DEverett School Dist DMukilteo School Dist Add'I RCW 64.55 docs required prior to final? 0Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ 22 - " Approved By: 'M )14 Date: 1 , 1-7 v PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffc Mit Eval ❑Site Work or Drainage Proposed Approved � - - Date: e-7//6/,0?-0 ❑Backflow Prevention for high hazard: :(dental,medical,animals,mortuary,hospital, !supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) OFire Sprinklers ❑Fire Alarm El Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred Additional Notes: 0 This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ 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) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: