2026 E GRAND AVE NURSING EVOLUTIONS 2022-05-13

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) 11 PERMIT# t O 0°—\ 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. ❑ 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 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement El 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 El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit:_ RCW 64.55 MF worksheet req'd for permit? El Yes ❑ No 0 Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total $ 12, Soo Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: turcui-c " I,'av aj"9�� `❑Sys Dev Eval ❑Traffic Mit Eval l 4;t y nnf r ❑Site Work or Drainage Proposed Approved By: �/ Date:!y)vqa.etaA=, I^„ ,�/ ac i Lj7 '❑Backflow Prevention for high hazard: j1gWX :(dental,medical,animals,mortuary,hospital, 'supportive housing) FIRE 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: EIThis Permit is Approved by Public Works ❑ 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 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) En Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: L:a:J�-ei Date: f /(0/W ❑ Public Works has no scope--- PW Not Required / f Additional Notes: ELECTRICAL LoW ES"FIM`a'tG S. V QEarntT" rtGavkiilt,b I. Additional Notes: Approved By: Date: Approved By: A N Date: 1 t;3!20 ' Z./2,