1130 SE EVERETT MALL WAY HOME GOODS 2023-06-22

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# gold 0q'©4/0 • - BUILDING •LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone I-vv Overlay/Agreement ❑ Route to Commercial Building Nonresidential UseFA-AA ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: B14/1 Idn/Rem Size 2`/347 ,v'1 Total No.of Dwelling Units: Garage/Accessory Struct. Size //✓A Planning/Landscape Inspection Required b ore Final? ❑Yes gNo Number of Stories / "In Lieu"Fee:Type: .- Amount$ Basement ' EiNo ❑Yes , Fin/Unfin s School Impact Fee: Total $ Type of Construction Calculated: edit: Occupancy Group /l'f ❑Everett School Dist ❑M Iteo School Dist Occupancy Load 3 Y 6 Park Impact Fees for permits,applied for after 1/1/2022: Fire Sprinklers: Update Existing ONew System ❑Not Req'd Park Impact Fee Total$ U Reason Sprinkle Required: Fee Schedule Used For Calculation(Year): Z402 L. Fire Alarm: OUpdate Existing ❑New System ❑Not Req'd Permit Technicians:Apply 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 El No ❑ 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$/8M Additional Notes: 00 edv_ ve..05 _ Approved By: lL, Date: a,Z f.2 2— BLIC WORKS Additional Notes: Intake OK b Date: a/J. i1i j 2/2/ Intake Commen s: PWWorksheetNe ded if. ❑Sys Dev Eval OTraffic Mit Eval 'I',--- ❑Site Work or Drainage Proposed Approved llik•,71(L.t-W Dater ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate!Deferred S bmittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet Fire Sprinklers 01.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: ❑ 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 la Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder join with this folder for permit issuance) Approved By: K,R,r, /(1 Date: /4--3 ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Public Works has no scope---PW Not Required—'11C/ ELECTRICAL/PLUMBING Additional Notes: "GA Z /[24!/ Additional Notes: Approved By: Date: Approved By: Date: 12.