910 SE EVERETT MALL WAY PEARLE VISION 2024-06-21

• Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) I PERMIT# Oo€3'"00( 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 0 OK to Route to Other Departments Bldg/Tl/Addn/Rem Size 0 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 El New System ONot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.56 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total$ • Approved By: Date: .. PUBLIC WORKS' Intake OK by: Date: Additional Notes: Intake Comments: IPW Worksheet Needed if: I OSys Dev Eval ❑Traffic'Mit Eval • 'Mite Work or Drainage Proposed Approved By: Date: 1❑Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Su mittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ['Fire Sprinklers 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 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(loin with this folder for permit issuance) eview/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:.1. /-1LK('(2(7 Date: 0/2/2 . ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL - Y IA.U1j�+(�'Y , OS1O?�z2- Additional Notes: f Y1 Approved By: Date: Approved Byikiiitt tN M Date: 5_lo/7b?7"