9001 AIRPORT RD BLDG 4 2025-10-27

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # 9A,303�© 57 BUILDING Intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bidgrl'I/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement []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'l RCW 64.56 docs required priorto final? ❑Yes []No VALUATION CALCULATION: Total $/Lra 000, 6 Additional Notes: Approved B • Date: ®3 FIRE DEPARTMENT Separate / Deferred Submittals Required: ❑Fire Sprinklers JUFire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE 11721 Review/ Inspection Scope -ADD FIRE FEE Approved By: Date: & . ELECTRICALM.LUMBING Additional Notes: Approved By: Date: ANNING 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 $ i Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Park Impact Fees for permits applied for after 11112022, Park Impact Fee Total $ /-.1 (net due after credit for existing uses) Fee Schedule Used For Calculation (Year): ................................................................................ Permit Technician Use Only: Apply Phase -In Credit Per EMC19.63.200 ❑ 100% Credit -Issued 111 /2022 - 9/2/2022 ❑ 50% Credit - Issued 9/3/2022 - 6/2/2023 ❑ 0% Credit - Issued 6/3/2023 or later Additional Notes: Approved By: Date: PUBLIC WORKS Intake OK by: Date: ---------------- --------------------- - Intake Comments: :PW Worksheet Needed if. []Sys Dev Eval (Util/s" ElTraffic Mit Eval ❑Site Work/Drainage ElAddress Letter ❑Backffow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, .supportive housing) .-----.................................... ❑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 ❑Deferred This Permit is Approved by Public Works See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ► l 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: iCompletedBy: Date: