1415 52ND ST SE EVERETT STAR ADULT FAMILY HOME 2022-10-31

QOLLECS P�5 Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 2 7 —O 4 Z.. BUILDING PLANNING • Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 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 44-1" ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size — Zone Z 1 Number of Stories Overlay/Agreement Basement ❑No IQIYes,CED/Unfin Nonresidential Use . Type of Construction CL-G Residential Use SV`, - Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No.of Dwelling Units: QNC Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: rt�� "In Lieu" Fee:Type: Amount$ Fire Alarm: El Update Existing ❑ LNew System �1Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cr:. RCW 64.55 MF worksheet req`d for permit? ❑Yes RI No ❑Everett School Dist 0 .I teo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes I No Additional Notes: VALUATION CALCULATION: Total$ ZCj D[7v Approved By( Date: \ PUBLIC WORKS- Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval • ❑Site Work or Drainage Proposed. Approved By: Date: Z i L(2D - -- ❑Backflow Prevention for high hazard: {{ (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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted 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 El 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: Date: