4920 EVERGREEN WAY RITE AID 2022-02-02

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLr 16 PERMIT # BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement []No OYes, Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update isting ❑New System ❑Not Req'd Reason Sprinklers Re fired: Fire Alarm: ❑ pdate Existing ❑New System []Not Req'd Reason Fire A m Required: RCW 64.5 F worksheet req'd for permit? ❑Yes ❑ No Add'[ R6W 64.55 docs required prior to final? ❑Yes ❑ No VALUATION CALCULATION: Total Additional Notes: Approved By: Date: l FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers []FireAlarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING' Intake OK by: Assign To: Date: Intake Comments: Z�,, � w� A ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units:. Planning/Landscape Inspection Required before Final? ❑Yes RNO "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: -I BLIC WORKS Intake OK by: Date: :..,-. ............ .............._..................,........,..._.,.,....,.,..................__-........,. ,-.....,.,...,,,.,., Intake Comments: =PW Worksheet Needed if.• []Sys Dev Eva] OTraffic Mit Eval ❑Site Work or Drainage Proposed 1 ❑Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, =supportive housing) 3 El Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder []Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works " ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ WIII be issued separately (separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: