220 SE EVERETT MALL WAY 2024-05-02

Intake &Approval Sheet !FOR PERMIT STAFF ONLY) • PERMIT#52201Lo—tr 10 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: J ess Date: I b`Ote/t2. Intake Comments: Intake Comm . El Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 121,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 El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? Mes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System El 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 ❑No Additional Notes:Correc+%or1 (e+i-e.r 3/al A}}actie.ct t'n cite VALUATION CALCULATION: Total$ ( d J009 Approved By: rj Date: //Z/23 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: I❑Sys Dev Eval ❑Traffic Mit Eval Mite Work or Drainage Proposed Approved By: Date: ( ¢;2, DBackflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, lsupportive 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 El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑This Permit is Approved by Public Works 0 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 0 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: Date: ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: