9001 AIRPORT RD BLDG 2 2023 2025-10-21

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT #_ AA � 3 03--0 0�)- BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit BldgM/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement [I No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing []New System []Not-Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'1 RCW 64.55 docs required prior to final? ❑Yes ONO VALUATION CALCULATION: Total $ 1�r_Tc�0,c5t9 Additional Notes: Approved SpDate;,jJg, �Z� i FIRE DEPARTMENT Separate Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review / Inspection Scope - ADD FIRE FEE Approved By: Date: EL.ECTR,ICALIPLUMBING Additional Notes: Approved By: Date: :INNING Intake OK by: Assign To: Date: Intake Comments: Zone (� Overlay/Agreement Nonresidential Use Residential Use Proposed No, of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Park Impact Fees for permits applied for after 11112022: Park Impact Fee Total $/ (net due after credit for existing uses) Fee Schedule Used For Calculation (Year): ................................................................................ Permit Technician Use Only: Apply Phase -in Credit Per EMC19.53.200 ❑ 100% Credit- Issued 1/1/2022 - 9/2/2022 ❑ 60% Credit - Issued 9/3/2022 - 6/2/2023 ❑ 0% Credit - Issued 6/3/2023 or later Additional Notes: -2 Approved By: Date: PUBLIC WORKS Intake OK by: Date: Intake Comments: ;PWWorksheeiNeededif: ^-..--- ----. � C(Sys Dev Eva] (Util/sM ❑Traff]c Mit Eval ❑Site Work/Drainage ❑Address Letter ❑8ackflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, 'supportive housing) - - -Y ❑Route this folder for PW Review at end-PWRevfew Worksheet~- ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder [Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit M PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ Will be issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope -- PW Not Required Additional Notes: Completed 13y. Date: