I know natively NS doesn't have approval routing for entity creation (customers and vendors). I've played with a workflows (that inactivate the entity) that are clunky and can be broken by users and we are wanting to avoid scripts if possible. The other big issue is needing users to have edit access just to attach documents. Is there a way around that permission?

yeah I hear you... I have experimented with vendor Approval Workflows in the past

You are right, so in my previous project, I created a "Approval" workflow for this.

I know you said avoid scripts but I've handled that type of permission scenario using a suitelet. Provides users a way to do specific task without actually having the permission.