11127 EVERGREEN WAY 2026-01-05 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#-n 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: Bldg/TI/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 ONO ❑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 El New System ❑Not Req'd Park Impact Fee Total Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System [hot Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: © 100%Credit-Issued 1/l/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add l RCW 64.55 docs required prior to final? ❑Yes ❑No 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ Additional Notes: Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: :.. ..__..............._,.,,.__....... _, _.._.. _.._.,...,..,.,..__ Intake Comments: I PW Worksheet Needed if, OSys Dev Eva] ❑Traffic Mit Eval Approved By: Date; a =f]S'ste Work or Drainage Proposed J 1❑Backflow Prevention for high hazard: '(dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate 1 Deferred Submittals Required: ❑Route this folder for PW Review at end^---PW Review Worksheet~w� ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works Fire Dept. Fees: ❑ 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 ❑ is in a Separate Green Folder Qoin with this folderfor 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: Approved By: Date: