1425 SE EVERETT MALL WAY GAME ON NW 2022-04-01

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# V211 C) —O5 BUILDING . , , PLANNING Intake OK by: Date: Intake OK by:_ Assign To: Date: Intake Comments: Intake Comments: e ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/A iem sj.„461 I6 ill Ill Hold in Planning File Drawer Garage/Accessory Struct.Size -^-- Zone N% - Number of Stories / Overlay/Agreement Basement io ❑Yes, Fin/Unfin Nonresidential Use . \s jC kzc,NQ� _ Type of Construction • //g Residential Use Occupancy Group JC1`.3 Proposed No.of Dwelling Units: Occupancy Load lr� Total No.of Dwelling Units: Fire Sprinklers: 119pdate Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Re ' ed before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: Jpdate Existing ❑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 I'No DEverett School D' t ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes J2tio Additional Note . VALUATION CALCULATION: Total$P 5CO Approved By: / Date: \\,Q \,'1,\ PUBLIC WORKS' Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: DSys Dev Eval ❑Traffic Mit Eval ' ' . i Mite Work or Drainage Proposed Approved B : Date:f��Vtc.,,z4 ;❑Backflow Prevention for high hazard: i(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) .moire Sprinklers , ire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ', ❑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 ❑ 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 n Date: //` 6 / ❑ Public Works has no scope PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: (._. �Z!