11400 EVERGREEN WAY 2022-06-28 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# --O BUILDING , PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: 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 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement ❑ 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 ewSystem ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: El Update Existing El New Syste ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes No El Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total $ I JUG."', A) Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: !PW Worksheet Needed if: I❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved B A_✓ Date: (,�zy P?.z' I❑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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: —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 0 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:K.,pjm,_,,,n Date: g-41,2 4 ❑ Public Works has no scope--- PW Not Required Additional Notes: Cass T.-fA+„, -2_00 sG re-C9t- io ELECTRICAL t-tk.D 5,Jr4-h� /r-R /! A sctJi. -rLv /gis..aosc: Pea.+w.T Additional Notes: j� Approved By: Date: Approved B ,C� Date: / ' C1`T „. Z.c Z=c. IL1.