9001 AIRPORT RD BLDG 5 2025-10-21

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # ��iv��-� -- D 4g g BUILDING intake OK by: Date: Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit B1dgiTl/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'I RCW 64.55 docs required prior to final? ❑Yes ❑No VALUATION CALCULATION: Total $'T LP� as Additional Notes: Approved B . Date: 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: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date:, BANNING intake OK by; Assign To: Date; Intake Comments: Zone U 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 Dish ❑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): ..er............................................................................ Pmi..t Technician Use Only: Apply Phase -in Credit Per EMC19.53.200 ❑ 100% Credit- Issued 1/1/2022 - 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: ;PWWorksheetNeededif- USys Dev Eva] (Util/SM ❑Traffic M]t Eval :[]Site Work/Drainage ❑Address Letter []Backflow Prevention for high hazard: (dental, medical, animals, mortuary, hospital, 'supportive housing) El 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 Ells in a Separate Green Folder (loin with this folderfor 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 )3y: Date: