10121 EVERGREEN WAY VALUE VET 2023-04-06

t. Z tog= 9• 4(0 Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# S 1 V D °°Z BUILDING PLANNING Q ,�,/ Intake OK by: Date: Intake OK by:� Assign To: 04S. Date:8/ii J�'�7 Intake Comments: Intake Comments: • ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit AOK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone INA L) Number of Stories Overlay/Agreement Basement El No ❑Yes, Fin/Unfin Nonresidential Use \GFC(t 1Gtr htx pi-la Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑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 ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ONo Additional Notes: VALUATION CALCULATION: Total Approved By:`^1�/�j Date: II/2.02,1 • PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: I PW Worksheet Needed if: DSys Dev Eval ❑Traffic Mit Eval =DSite Work or Drainage Proposed Approved By: ,igj Date: f it,j2.0L-1 OBackflow Prevention for high hazard: VV'' i • _(dental,medical,animals,mortuary,hospital, _supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end -PW Review Worksheetmy W Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers El 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 ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ 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: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: