10115 EVERGREEN WAY GROCERY OUTLET 2022-03-23

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) 0 PERMIT # K d 3_ D(06 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 31 to�l9 Garage/Accessory Struct. Size Number of Stories Basement INNo ❑Yes , Fin / Unfin Type of Construction (-j Occupancy Group M Occupancy Load Zq (p Fire Sprinklers: P9Update Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: IXI Update Existing [I New System []Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No Add'I RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ 00121000 Additional Notes: Approved By: Date: 5P2 xaxl FIRE DEPARTMENT 5te / DeferredSu ittals Required: e Sprinklers re Alarm []Other:Z Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE eview / Inspection Scope - ADD FIRE FEE Approved By: Date:-6 ELECTRICAL Additional Notes: Approved By: Date: PLANNING //^ Intake OK by: Assign Toro Date: Vf Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use I(0(x sivyt- Residential Use V 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: Date: PUBLIC WORKS Intake OK by: Date: w.. .......................... Intake Comments: DPW Worksheet Needed if., 1[]Sys Dev Eval ❑Traffic Mit Eval []Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: ,(dental, medical, animals, mortuary, hospital, _supportive housing) e...................................................._..................................................._................................._... ❑ 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 El Deferred ga'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 Qoin With this folderforpermitissuance) ❑ 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: