10633 EVERGREEN WAY 2025-01-10 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# 62105 - 019 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: del Date: 5/30IZ4I Intake Comments: Intake Comments: Zone ❑ Make this a "W" Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size / Nonresidential Use JQ)n'cl2 S molts //Ka"l{ Garage/Accessory Struct. Size Residential Use Number of Stories Proposed No. of Dwelling Units: Basement ❑No ■ 'es , Fin/Unfin Total No. of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes EiNo Occupancy Group "In Lieu" Fee: Type: Amount$ (� Occupancy Load School Impact Fee: Total $ 12 Cert. of Occpuancy Req 'red? ❑No ❑Yes ❑Shell Only Calculated: Credit: Code Year 02021 02018 02015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: Update Existing El New System ['Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Spri 'lers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alar . El Update Existing El New System El Not Req'd Fee Schedule Used For Calculation(Year): Reas. Fire Alarm Required: RC 164.55 MF worksheet req'd for permit? ❑Yes ❑ No •dd'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: lAitc'°r — ( .- VALUATION CALCULATION: Total $ ,' 000 6 � Approved By: --adi-A.% Date: .00/7,/PUBLIC WORKS Intake OK by: Date: Intake Comments: I PW Review&Worksheet Needed if: Dev Eval : 10Sys ❑Water ❑Sewer ❑Storm Additional Notes: / I❑Traffic Mitigation Eval Approved By: ''t Date: j•7/0.7 1OSite Work/Drainage(shown/triggered) I❑Address Letter — I FIRE DEPARTMENT I❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: !(dental,medical,animals, mortuary, p q :hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm El Other: . Additional Notes: 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope- NO FIRE FEE 0 Is located in this folder O Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ublic Works has no scope on this permit--- PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By`" eAt SpA Date: L) 5 if 0 I zirz-1