8102 EVERGREEN WAY EVERETT 4 CORNERS - BLDG D 2025-08-06

Intake &Approval Sheet FOR PERMIT STAFF ONLY) PERMIT# N1 2.2D CO — 0D0' BUILDING PLANNING //�� I�� Intake OK by: Date: Intake OK byf yv i \ t.Y Assign To: Date: /ci/- Z Intake Comments: Intake Comments: o - t02.- every-eerI �J ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone 1 1 1 U Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use t!'�.!ir' ' aAO) Type of Construction Residential Use (Thi -JI vi lw Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing ONew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ iuw i , ( 122 Approved By: Date: PUBLIC WORKS Intake OK by: Date: • Additional Notes: Intake Comments: PW Worksheet Needed if ❑Sys Dev Eval ❑Traffic Mit Eval Site Work or Drainage Proposed Approved By: Date: j fa�- ❑Backflow Prevention for high hazard: !{dental,medical,animals,mortuary,hospital, (supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end --- PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review (Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 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 located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder (loin with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately (Separate Green Folder,PW Issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: