5631 EVERGREEN WAY 2023-06-29 - Laserfiche WebLink

Intake &Approval Sheet 410 (FOR PERMIT STAFF ONLY) 0 PERMIT#3221)C0-1) ( BUILDING PLANNING • Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: LY-)2 ' 0\e . fs2c- 51 kiSK) ❑ 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 SJ9Z4 ,S'F El Hold in Planning File Drawer Garage/Accessory Struct.Size /� Zone Number of Stories Overlay/Agreement Basement rEtNo Oyes, Fin/Unfin Nonresidential Use Type of Construction V i Residential Use Occupancy Group F-0/4 Proposed No.of Dwelling Units: Occupancy Load lZ Total No.of Dwelling Units: Xes Fire Sprinklers: ❑Update Existing ❑New System NNot Req'd Planning/Landscape Inspection Required before Final? ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: Pitipdate 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 al No El Everett School Dist ❑Mukilteo School Dist Addl RCW 64.55 does required prior to final? ❑Yes NNo Additional Notes: 66 old ; Ay P VALUATION CALCULATION: Total$ 7,64 O'O•00 9i ce" `ir--rey. Approved By: Y.., C r Date: Cf.,1 2,Z, SIP'UBLIC WORKS/�c�Intake OK by: . Date vf\14\ D'2i2" Additional Notes: 61 )ze'n- Intake Comments. Lri( f4? pw Worksheet weeo'edif. Dl I W W Plargib 11641l 14'�'cq:• �(1� Dv"v"' J��,�� f' ' L1 Sys Dev Eval ❑Traffic Mit Eval / l` 01 , r-V 3� ❑Site Work or Drainage Proposed Approved BXv Date: 09/Z�/7.62,2Pt/►"uttsTe� IDBackflow Prevention for high hazard: y =(dental,medical,animals,mortuary,hospital, 46 I C'. In i rdV', I 6'1 _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 tiElFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ND ,'C6/PE' 1610 D F1.4£44- 4-ii'l SI This Permit is Approved by Public Works RI See PW Review Worksheet and associated attached items Fire Dept. Fees: • liZI A Separate PW Permit is Required(Permit#:PW 22M-0t€ ) ❑ Review of As-Built Plans-NO FIRE FEE AND 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/lnsp ion Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: -'4 ��ti1!J4 Date: 07//�/7.hr,U ElPublic Works has no scope---PW Not Required Additional Notes: ELECTRICAL WIGOA.4rni 9.4C.07 re/VW Q WV& Additional Notes: Approved By: Date: Approved By:ittinitta,401 )Date: of l a e x7/32 . 3