6101 EVERGREEN WAY 2023-02-06 - Laserfiche WebLink

Intake &Approval Sheet ,FOR PERMIT STAFF ONLY) PERMIT# )32—It O� 1 J BUILDING •ANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Ill Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use C WOIL/ ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Addn/Rem Size Total No.of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu" Fee:Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin s School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group DEverett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System ONot Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: DUpdate Existing ❑New System ❑Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 does required prior to final?c�❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ 7Z/ 4697.Da Additional Not s: r(lo‘ A-'U• - \ /I 0/7L Approved By: Date: ,�PUBLIC WOR /� Additional Notes: Intake OK by: y o Wv2/ Date• Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Approved Date:/0/P.-o Z ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers OFire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works Fire Dept. Fees: ❑ See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder ' ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) VI Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: -6,14/1114O\ APWAAA-1 16q1(141V Approved By: Date: Approved By: Date: 2-JZ