6320 EVERGREEN WAY VERIZON WIRELESS ANTENNA 2019-09-05

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# BUILDING PLANNIND Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Co nts: Assign To: 011\— ❑ Route to Commercial Building EfAttach to Project No. 6 V I (o O 1O ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement 1-AO( Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Lit 4.(265 Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 9No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo S ool Dist �� Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: 6j)jo��.- o\ ccy4Chon oF VALUATION CALCULATION: Total$ 6�J 1�s '��TT'^"''' Approved By: ICI j 4.1 Date: -2_Zs.,jc Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date: /(9 ❑Backflow Prevention for high hazard: ` (dental,medical,animals,mortuary,hospital, ,F - ,i *0:;0 PAi tT EN'S`, ,,; , „ , El Route this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: ❑update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required(Permit#: PW Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ ADD FIRE FEE 0 NO FIRE FEE 0 Public Works has no scope---PW Not Required Approved By: Date: Additional Notes: Additional Notes: Approved By: Date: Approved By: Date: