10633 EVERGREEN WAY 2025-01-10 - Laserfiche WebLink

Intake & Approval Sheet IIIR PERMIT STAFF ONLY) iiri ERMIT# 61! Os--U`0 BUILDING PUNNING Intake OK by: Date: Intake OK by: Assign To: ;QK% Date: 5/36/24 Intake Comments: Intake Comments: Zone (5_ El Make this a"W" Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size // Nonresidential Use Garage/Accessory Struct. Size Residential Use v/- tclt $A1ts /N11, 4.4-- Number of Stories Proposed No. of Dwelling Units: Basement ❑No ❑Yes Fin/Unfin Total No. of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes KiNo Occupancy Group "In Lieu" Fee: Type: Amount$ Occupancy Load School Impact Fee: Total $ 0 Cert. of Occpuancy Require.. ❑No ❑Yes ❑Shell Only Calculated: 75 Credit: Code Year 02021 ❑2018 1:12015 El Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑u.date Existing El New System ❑Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinkl: s Required: Park Impact Fee Total$ f (net due after credit for existing uses) Fire Alarm: CI Update Existing El New System El Not Req'd Fee Schedule Used For Calculation(Year): Reaso ire Alarm Required: RC 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Jadd'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: tt"W'u1 - v.-1-4 19%;�� "^t VALUATION CALCULATION: Total $ 1 coo v / Approved By: ---Q ,K' ,/ � Date: Sip,/2 M PUBLIC WORKS Intake OK by: Date: Intake Comments: IPW Review& Worksheet Needed if: ❑Sys Dev Eval : Additional Notes: Viii,VAT1O� i,((. Raid(il jtort ❑Water ❑Sewer ❑Storm • OTraffic Mitigation Eval Approved By �, Date: ' `�/Z02i-t ❑Site Work/Drainage(shown/triggered) 1 �' ❑Address Letter FIRE DEPARTMENT jOBackflow Prevention for high hazard: Separate/Deferred Submittals Required: Ihospita(dental,medical, animals, mortuary, p q 'hospital, supportive housing) El Fire Sprinklers ❑Fire Alarm DOther: • Additional Notes: ❑ This 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 ) ❑ Review of As-Built Plans- NO FIRE FEE AND 0 Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ 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) Public Works has no scope on this permit--- PW Not Required ELECTRICAL/PLUMBING dditional Notes: Additional Notes: 1 Approved By: Date: Completed B � Date: V S- to/Z