11030 EVERGREEN WAY 2021-03-31 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#l V\ �� 03 \ BUILDING f� PLANNING Intake OK by: Date: Intake OK by"`A V Assign To: Vit04 t.Date: / '/yy Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a "W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer /} Garage/Accessory Struct. Size Zone I- nit t 0 0 Number of Stories Overlay/Agreement Basement ONo ❑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 El 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 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 El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total $ Approved y:06 Date: ✓ 1, PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: Sys Dev Eval OTraffic Mit Eval Site Work or Drainage Proposed Approved By: Date: 2' e22 n Backflow Prevention for high hazard: cr"--- (dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT El 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) O Fire Sprinklers OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred Additional Notes: 0 This Permit is Approved by Public Works ❑ 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 O Minimal or No Fire Scope- NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) O 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 Additional Notes: Approved By: Date: Approved By: Date: