10121 EVERGREEN WAY KID STRONG 2023-05-19

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1223Pi " 044-- BUILDING lip LANNING Intake OK by: Date: i 03 Intake OK by:A-LL)CG. Assign To: j__ Date: I/l'7/Z.3 Intake Commen : Intake Comments: Zone (Y) Overlay/Agreement cpnller Route to Commercial Building Nonresidential Use byui-ex}ni i--4 oreaka_ ❑ Route to Residential Building Residential Use ❑ Make this a"W"Permit Proposed No. of Dwelling Units: Bldg/TI/Addn m Si (I/73 1-10 Total No.of Dwelling Units: Garage/Accessory Struct. Size , Aszi Planning/Landscape Inspection Required before Final? ❑Yes ON() Number of Stories ( "In Lieu"Fee: Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ ei Type of Construction --8 _ Calculated: Credit: Occupancy Group / ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load 6'3 Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ❑New System pNot Req'd Park Impact Fee Total$ 71 (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: DUpdate Existing ❑New System ZINot Req'd Permit Technician Use Only:Apply Phase-In 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 IR No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes to 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$97 d Oc7 D° Additional Not : / Approved By: Date: • PUBLIC WORK Additional Notes: Intake OK by: Date: Q .1211i Intake Comme PW Worksheet Needed if: ❑Sys Dev Eval(Util/SW)[]Traffic Mit Eval Approved B . Datep26wT,oz3 ❑Site Work/Drainage ❑Address Letter ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate I Deferred Submittals Required: DRoute this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers .Fire Alarm ❑Other: OThis project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 0 This Permit is Approved by Public Works Fire Dept. Fees: 0 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 El Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: ,E f n Date:a� 2E�/�3 El Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) IA Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: 0 d a Igo v7 Approved By: Date: Completed B . Date: