902 PINE ST NORTH SOUND BEHAVIORAL HEALTH TREATMENT CENTER 2021-12-10

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) le PERMIT# S 2.. 1 61. —6 o5 BUILDING • PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: cart&-40M iaci <Peaf"4. 12. z/ ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone U 2_4 Number of Stories Overlay/Agreement SIc h(12 . C Basement ONo ❑Yes , Fin/Unfin Nonresidential Use U 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 before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El 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 ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑_Yes El No Additional Notes: �)VALUATION CALCULATION: Total$ 00 Approved By:C.CJf7 Date: 811012411 PUBLIC WORKS' Intake OK by: Date: Additional Notes:,54/4 &a/j�/7 (AV) Intake Comments: PW Worksheet Needed if: I❑Sys Dev Eval ❑Traffic Mit Eval Noby c ( ,�`d -x U� 1 I-/ 1 L. _9 3OSite Work or Drainage Proposed /� �j ❑Backflow Prevention for high hazard: Approve By:L Date: G 21 (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT El 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 El Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted Previously ODeferred Additional Notes: 4 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items NI Ift 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 ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope---PW Not Required Additional Notes: A+ Qk n -b be_ /[pd -to ELECTRICAL LN1k-� _TT Additional Notes: Moto-0\� 901 T 1 r 1 E S+ 1 r or Aitoliii, „mar Approved By: Date: Approved ,,AF:jj Date: PA revoi-Kai AO j2e N- citz)