8125 EVERGREEN WAY DISCOUNT TIRE 2026-01-05

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#tNL r0� BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: !Dta _ Date: 2 ZO Intake Comments: Intake Comments: Zone ❑ Make this a"W"Permit ❑ SRC Required (Pre-Insp) Overlay/Agreement Bldg/TI/Addn/Rem Size / Nonresidential Use PIv'Fo So�'V�GG Garage/Accessory Struct. Size Residential Use Number of Stories Proposed No. of Dwelling Units: Basement ❑No ❑Yes, Fi /Unfin Total No.of Dwelling Units: Type of Construction Planning/Landscape Inspection Required before Final? ❑Yes ®'No Occupancy Group ! "In Lieu" Fee: Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required? ❑No ❑Yes ❑Shell Only Calculated: Credit: Code Year 112021 112018 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: El Update Existing El New System El Not Req'd Park Impact Fees for permits applied for after 1/1/2022: Reason Sprinklers Required: Park Impact Fee Total$ 4 [p (net due after credit for existing uses) 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 ❑ No Add'I RCW 64.55 docs required prior to final? []Yes []No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: 2 PUBLIC WORKS a� Intake OK by: Date: Intake Comments: PW Review&Worksheet Needed if. ❑Sys Dev Eval Additional Notes: ❑Water ❑Sewer ❑Storm j❑Traffic Mitigation Eval Approved By: V Date: + j[]Site Work/Drainage(shown/triggered) l ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental, medical,animals, mortuary, Ihospital,supportive housing) El Fire Sprinklers ❑Fire Alarm ❑Other: s Additional Notes: ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is fully digital ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑ 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: Approved By: Date: Completed By: Date: