1000 SE EVERETT MALL WAY US PROBATION COURT OFFICE 2023-05-19

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# 6-7 to o 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 ❑ 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: ❑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: ❑Update Existing New System ONot 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? ales No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: PUBLIC WORKS- Intake OK by: Date: Additional Notes: Intake Comments: lPW Worksheet Needed if:: f❑Sys Dev Eval ❑Traffic Mit Eval • DSite Work or Drainage Proposed Approved By: Date: ;DBackflow Prevention for high hazard: I(dental,medical,animals,mortuary,hospital, €supportive housing) FIRE DEPARTMENT CI 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) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted Previously ❑Deferred rt Additional Notes: 0 ❑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) TS-Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: ,1j j L'QY\ Date:65-.2 4 I ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: