11610 EVERGREEN WAY 2023-04-06 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) I PERMIT# 'i/0 5—o 014 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: \\‘ ,<e,(\ C-N`\RA,\1,6.%\rt Cvotak ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone �A Number of Stories Overlay/Agreement "IAC44\ •("k\si � f1 Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use ( '\de,-4141A AoV, . 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 b e Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El 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 ❑Everett School Di ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes' VALUATION CALCULATION: Total$_.9,, d4`® Approved By-" Date: \E:Zjai,k PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: 1PW Worksheet Needed if: IDSys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date:J C 5 p 1 o Backflow Prevention for high hazard: I(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT ❑Route 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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred • Additional Notes: ElThis 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 Cl 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: ViPublic Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: D3/2/ /1-02_t Approved By: Date: Approved By: Date: 7'