7920 EVERGREEN WAY 2025-08-22 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: JeSS Date: �J Z Intake Comments: Intake CommenTsV Zone ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg1TI/Addj/R'epAize 2 7 Nonresidential Use Food bevera e. Garage/Accessory Struct. Size Residential Use Number of Stories Proposed No. of Dwelling Units: Basement EINo ❑Yes , Fin/Unfin Total No. of Dwelling Units: Type of Construction y Planning/Landscape Inspection Required before Final? ❑Yes nX No Occupancy Group AY jl� "In Lieu" Fee:Type: Amount$U Occupancy Load ef'b School Impact Fee: Total $ Cert. of Occpuancy Required? ❑No ❑Yes ❑Shell Only Calculated: Credit: Code Year 1112021 112018 ❑2015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: pdate Existing []New System El Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ O (net due after credit for existing uses) rs� Fire Alarm: [ Update Existing ❑New System ❑Not Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes 'R No Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: VALUATION CALCULATION: Total$ �,��t 00'2 Approved By: Date: a 2 PUBLIC WORKS Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed If., []Sys Dev Eval: Additional Notes: f/) pYr$ W yrG✓ L f ❑Water []Sewer []StormII 1 []Traffic Mitigation Eval Approved By: Date: k P []Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, Se p q hospital,supportive housing) El Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: his Permit is Approved by Public Works 9See PW Review Worksheet and associated attached items Fire Dept. Fees: 5KA Separate PW Permit is Required (Permit M PW 2410 1'"0jos)' ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE 014s located in this folder Ed Review/Inspection Scope-ADD FIRE FEE r❑ Is in a Separate Green Folder(join with this folder for Permit issuance) Approved By: Date: — �- u2 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 Additional Notes: Additional Notes: Date: a 4(27 2a Approved By: Date: Completed By: 7