1100 PACIFIC AVE EVERETT BONE AND JOINT 2022-01-20

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# II M 1 I -062 BUILDING PLANNING Intake OK by: f.�'4( Date: Ili.1.\ t61 Intake OK b Assign To: CaC2 Date: \\-©A •CC'7V01 1J Intake Comment Intake Comments: -\- nP A.Sk Q�& t~2 t ei\A '34 5\*4\ rest e- C� °`. ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make thi "Permit ❑ OK to Route to Other Departments Bld�/TI/Addn Si& 200 tgl Hold in Planning File Drawer /ra /Accessory Struct.Size Zone LA'q Number of Stories LI Overlay/Agreement1 SSceA Autc2 l,se C c,ce;.*f Basement �No Dyes , Fin/Unfin Nonresidential Use Tke�. ¢� @ ' Type of Construction V4 Residential Use Occupancy Group /1 Proposed No.of Dwelling Units: Occupancy Load Z Total No.of Dwelling Units: Fire Sprinklers: ®Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes El No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: l pdate Existing El New System, School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 12 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes INo Additional Notes: VALUATION CALCULATION: Total$ fS j oa5,OD Approved ByaN1---- Date: 12 y V9 PUBLIC WORKS Intake OK by: •,, Date: (` Additional Notes: Intake Comments: I PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval i❑Site Work or Drainage Proposed Approved ByGk� Date:/j/ c),,zer, I ElBackflow Prevention for high hazard: �/ __ I(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 ❑Submitted Previously ❑Deferred Additional Notes: This Permit is Approved by Public Works El See PW Review Worksheet and associated attached items ,.....4/..,:. Fire Dept.Fees: `1 ❑ A Separate PW Permit is Required(Permit#: PW ) ❑ Review of As-Built Plans-N• FIRE FE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope 0 FIRE FEE ❑ Is in a Separate Green Folder coin with this folder for permit issuance) ❑ Review/Inspection Sc..e-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: r _!-4 Date: