6132 EVERGREEN WAY 2025-03-27 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1i _ BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Adds/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 School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 11112022: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Park impact Fee Total (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): »-------------- __---.---------------------•-------- Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.63.200 Reason Fire Alarm Required: 11 100%Credit-Issued 111112022-91212022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No El 50%Credit-Issued 9/3/2022-6/2/2023 Add']RCW 64.55 docs required prior to final? ❑Yes ❑No a 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: ;PWWorksheet Needed if- ©Sys Dev Eva[(utiusvv) ElTraffic Mit Eval Approved By: Date: ElSite Work/Drainage ❑Address Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT :supportive housing) ..............._----------____- Separate I Deferred Submittals Required: El Route this folder for PW Review at end ---PWReview Worksheet ❑Fire Sprinklers ❑Fire 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 Worksheot 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(loin with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope---PW Not Required ELEGTRICALIELILMBINAdditional Notes: Additional Notes: Approved By: All Date: 7_ Completed By: Date: