8825 EVERGREEN WAY LOS POTRILLOS 2024-10-16

Intake & Approval Sheet (FOR PERMIT STAFF ONL1) PERMIT# m�JDf-) -C)-7q 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: BldgRl/Addn/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 1/112022: Fire Sprinklers: ❑Update Existing ❑New System El Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: ❑ 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add1 RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total $3 7 00 L, 00 Additional Notes: rT,)Wa K,-," OP Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: _Date: Intake Comments: pW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Approved B Date:C>4 74- TeZ3 I[]Site Work or Drainage Proposed i❑Backflow Prevention for high hazard: MUM � 31s,mortuary,hospital, ��IVVV•lll FIRE DEPARTMENT CYP— Separate/Deferred Submittals Required: ❑Route this folde IW4 �S aY, lew Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project alsi ( view(Green Folder) Yt u Additional Notes: AND ❑Create Gr ab L ✓ ❑Deferred ❑ This Permit is) (A CI M (Jt V, Fire Dept. Fees: ❑ See PW Revie ed 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 goin 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 ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: lApproved By: Date: