8102 EVERGREEN WAY MALL KIOSK EVERETT 4 CORNERS - MAIL KIOSK 2025-08-06

Intake & Approval Sheet (FOR PERMIT STAFF ON09 PERMIT BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg I/Addn/Rem Size 769- iS r Garage/A sory Struct. e Number of Stories / Basement o ❑Yes , Fin / Unfin Type of Construction VS Occupancy Group Occupancy Load Fire Sprinklers: El Update Existing ❑New System PNot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System 12t4ot Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes IINo Add'1 RCW 64.55 docs required prior to final? ❑Yes .�.7 No VALUATION CALCULATION: Total $ Additional Notes: Approved B Date. O / / S 2 FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE bk�inimal or No Fire Scope - NO FIRE FEE pe - IRE F Vim" Approved By: J< f Date: ��(Q ELECTRICAL Additional Notes: Approved By: Date: PLANNING' Intake OK by: Assign To: �_ Date: Intake Comments. ❑ Attach to Project No. ❑ Route to Historic Reviewer OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes o "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: �, Date: 11 PUBLIC WORKS Intake OK by: Date: Intake Comments: jPW Worksheet Needed if.• ❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed I1113ackflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, Isupportive housing) L.......... ...................-..,..,................-........._..._.._................._.............................. ❑Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously—LkLakrred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated ached items ❑ A Separate PW Permit is Required (Permit . PW 2,011• ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join wit this folder for permit nuance) ❑ Will be issued separately (separate Gree older, PW ' ued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: