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CITY OF EVERETT <br /> E V E R E T T OFFICE USE ONLY <br /> WASHINGTON Permit Services Transmittal Date Received Stamp <br /> PERMIT/PROJECT#: 005 <br /> SITE ADDRESS: �t�✓� /��V) '5r <br /> PROJECT NAME: al <br /> FROM: I-I&W XASKI M61Jn177W COMPANY: GiV Chronology-Permit Counter Transmittal <br /> PHONE#: EMAIL: <br /> eel�--Ae—(�D ❑Plan Review Routing <br /> Location: ❑File []Reviewer Office <br /> /21�!?CCl3�1CC�rC/l� �•�, Date Logged: By: <br /> Rout o:(Check all that apply) Name of Reviewer / y of Review <br /> Planning Reviewer Name: �J,55,�d&ii �1I)l1-I(/% -Review <br /> ❑ Public Works Reviewer Name: ❑ Revisions After Approval <br /> ❑ Building Reviewer Name: ❑ Revisions After Issuance <br /> ❑ Fire Reviewer Name: ❑ Other <br /> ❑ Other Reviewer Name: ❑Other <br /> Provide quantities for all items submitted <br /> PLANS REPORTS/CALCULATIONS OTHER DOCUMENTS <br /> Qty Qty Qty <br /> Architectural/Building Plans _ Geotechnical Report _ Correction Letter Responses <br /> Structural Plans _ Drainage Report Draft Easement <br /> _/Civil Plans _ SWPPP Report _ Recorded Easement <br /> V Site Plan _ Wetland Report _ Height Survey <br /> _ Landscape Plan _ Critical Area Report Base Elevation Survey <br /> Survey _ Traffic Study/TDM Report Critical Area Covenant <br /> _ Elevations Structural Calculations Stormwater Covenant <br /> Floor Plans _ Height Calculations _ Covenant-Other <br /> _ special Inspection Report Plumbing Calculations Performance Guarantee <br /> _ As-Builts _ Other _ Warranty Bond <br /> Plat Maps _ Other _ Other <br /> Original City Redlines Returned Other Other <br /> Other Other Other <br /> Other Other Other <br /> Items submitted are: <br /> ❑Complete Plan Set Replacement Additional Documents <br /> (Slip-sheeting not permitted) (To be added to file) <br /> Comments to Reviewer: FOR CHANGES IN SCOPE: <br /> Revised Description of Work: <br /> Revised Valuation: 6v� LQ&I'j ©V <br /> Signed: Date: - - i � <br />