8630 EVERGREEN WAY $1 STORE 2021-12-16

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# s 1. 0-0 BUILDING PLANNING Intake OK by: Date: Intake OK by:,9 ' 2 Assign To: Y1( Date: )di. d/l 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 OK to Route to Other Departments Bldg/TI/Addn/Rem Size Hold in Planning File Drawer Garage/Accessory Struct.Size Zone j✓ I VIA + Number of Stories Overlay/Agreement Basement El No ❑Yes, Fin/Unfin Nonresidential Use esta{ 1 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 ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes "No Reason Sprinklers Required: "In Lie :Type: Amo Fire Alarm: ❑Update Existing DNew System El Not Req'd School Impact al $ Reason Fire Alarm Required: Calculated: it: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everg ool Dist ❑Mukilteo School Dis Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total Approved By: OIL Date: i2,./J Q 4G1 '�° PUBLIC WORKS ! ' 1 Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval =OSite Work or Drainage Proposed �� Date: 12 ❑Backflow Prevention for high hazard: Approved By: G '19 (dental,medical,animals,mortuary,hospital, supportive housing) IRE 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) El Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: El 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 ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ 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: vic,,ublic Works has no sc a PW Not Required Additional Note • it4/19 ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: (g2)