9204 EVERGREEN WAY 2022-04-01 - Laserfiche WebLink

f • II V o Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# fn 21`) )- k12 BUILDING PLANNING Intake OK by: Date: Intake OK by: /� Assign To. )gyp �"1 "� ��d`�P a Date: ID/2-6,12..eq Intake Comments: Intake Comments: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit WOK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use 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 CI No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: CI Update Existing CI New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No CI Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total $ /1, 000,0G Approved By:(),/,.. Date: Jo � �u l / PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: [PW Worksheet Needed if: ❑Sys Dev Eval Traffic Mit Eval ❑Site Work or Drainage Proposed Approved Byr %,//':%.: Date:/off 7/;e� ❑Backflow Prevention for high hazard: :(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT DRoute 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 CI Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works 0 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 0 Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder Qoin 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: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: