510 SW EVERETT MALL WAY JUDD & BLACK 2022-08-11

F42 °2-003 Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# EZI/O aC! BUILDING PLANNING- Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ 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 ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑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: El 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!RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total Approved By: Date: PUBLIC WORKS-- • Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if:: 'DSys Dev Eval ❑TrafficMit Eval • ❑Site Work or Drainage Proposed Approved By: Date: I0Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, isupportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted Previously ❑Deferred Additional Notes: ❑This 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 ❑ 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 • „„ad, Date: ;2,'-‘2,2 ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: