11400 EVERGREEN WAY 2021-11-03 - Laserfiche WebLink

Intake & Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT#bZ O -001- BUILDING PLANNING Intake OK by: Date: Intake OK Assign To: Date: k0.-A.Z02c Intake Comments: Intake Comm s: ❑ Route to Commercial Building ❑ Attach to Project No. / ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Mathis a"W" Permit 0 OK to Route to Other Departments Bldddn/Rem Size ///)d ❑ Hold in Planning File Drawer / Garage/Accessory Struct. Size ,t//4 Zone / Number of Stories ( Overlay/Agreement ; Basement No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction MI, 5/, A-Z, B Residential Use Occupancy Group ,T , Proposed No. of Dwelling -nits: Occupancy Load ,c/%,j Total No. of Dwelling U •s: Fire Sprinklers: ❑Update Existing ❑New System VINot Req'd Planning/Landscap= Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee:Type Amount$ Fire Alarm: El Update Existing ❑New System,Not Req'd School Impact F•e: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ® No ❑Everett :chool Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes Liallo Additio : Notes: VALUATION CALCULATION: Total $7,e5 oc'a.00 ‘el, O\- Ctg91L�VN44Z Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval OSite Work or Drainage Proposed I❑Backflow Prevention for high hazard: Approved B ,�Y/ Date:/e/brr/ p :(dental,medical,animals,mortuary,hospital, / ;supportive housing) FIRE DEPARTMENT ❑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) ❑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: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans- NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ 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: