221 SE EVERETT MALL WAY ZOOM + CARE 2022-03-09

• • 2�a�faa 1 Intake & Approval Sheet (FOR PERMIT STAFF ONLPERMIT #_ BUILDING Intake OK by: Date: Q- ;242.4 Intake Commen s: Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size — Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Y?_ Occupancy Group e Occupancy Load IIF, Fire Sprinklers: ❑Update Existing ❑New System XNot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing W New System ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes M No Add'I RCW 64.55 docs required prior to final? ❑Yes Q No VALUATION CALCULATION: Total $ --';m 4VO Additional Notes: I Approved By: IaLDate: 22 p FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers El Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ® Review / Inspection Scope -ADD FIRE FEE Approved By: A Date: . -24 ELECTRICAL Additional Notes: Approved By: Date: PLANNING Intake OK by:(A4L> Assign To Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer I K to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use rh ri r L Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes PLO "In Lle e: Type: ount $ School Impact Fee: 1 $ Calculated: El Everett of Dist ❑Mukilteo School Dis A tonal Notes: Approved By: Date: PUBLIC WORKS Intake OK by: Date: ............ ..... ...... .... ...... ...... ..... .................. ...... ..... .... ..................,,.,.,,...,,,,................ Intake Comments: PW Worksheet Needed if., ❑Sys Dev Eva ❑Traffic Mit Eval s❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: .(dental, medical, animals, mortuary, hospital, supportive housing) ❑ Route this folder for PW Review t end - PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder of is folder for permit issuance) ❑ Will be ISSUed SeparatEeparate Green Fo PW issued ahea VPublic Works has no scop --- PW Not Require n Additional Notes:n4v' e of ULP . Approved By: Date: c