1010 SE EVERETT MALL WAY BASE FILE 2023-06-16

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) PERMIT#51:507, 0 3 BUILDING �LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use O `CC, ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Addnlem Siz Total No.of Dwelling Units: Garage/Accessory Struct.Size WO Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories 'Z- "In Lieu"Fee: Type: Amount$ Basement IRINo ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction -6 Calculated: Credit: Occupancy Group El Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System tiNot Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: DUpdate Existing ONew System Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes No 0 50%Credit Issued 9/3/2022-6/2/2023 Add!RCW 64.55 docs required prior to final? ❑Yes EINo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$/�S�'fJ•dV Additional Notes: i-xiv.00_,Pt q127/z3 Approved By: Date: • PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: OSys Dev Eval(Util/SW)[]Traffic Mit Eval A roved B Date: b2� /� ❑Site Work/Drainage ❑Address Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑This Permit is Approved by Public Works Fire Dept.Fees: 0 See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#:PW___________) ❑ Minimal or No Fire Scope-NO FIRE FEE AND 0 Is located in this folder Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: r 'COCitJ n Date: -3-G27,23 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope---PW Not Required ELECTRICAL/PLUIIIIBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: