7601 EVERGREEN WAY CHOICES SCRUBS AND MEDICAL 2022-02-03

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLV) • PERMIT # S 2 1 d't , ®0 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit BldgRl/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System Mot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Reason Fire Alarm Required: . RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add] RCW 64.55 docs required prior to final? ❑Yes ❑ No VALUATION CALCULATION: Total $ Additional Notes: Approved By: Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑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 D . Date: f'2 Intake OK by:� Assign To: (.Qi`�'p Intake Comments: ❑ Attach to Project No. Voute to Historic Reviewer K to Route to Other Departments old in Planning File Drawer Zone Overlay/Agreement j CGL Nonresidential Use . Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? []Yes []No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: El Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By:Ow Date: Z ,�.� PUBLIC WORKS` Intake OK by: Date: :............... .......... ........................ ................................................. ..... w.................... ...... ............... Intake Comments: 1PIN Worksheet Needed if. sIJSys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backf ow Prevention for high hazard: !(dental, medical, animals, mortuary, hospital, ,supportive housing) ...,,........................ ............. .................. ,.......... ......... .,.....,,....,....,............. .... ......,............... ..,.. ❑ 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 ' :2, ' ❑ 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) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: