3409 ROCKEFELLER AVE 2021-09-08 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#� 1 (53 BUILDING PLANNING Intake OK by: Date: Intake OK by:4_ Assign To:RIA, Date: V c-726 Intake Comments: Intake Comments: (�_ ,01 / ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building Route to Historic Reviewer ❑ Make this a"W"Permit K to Route to Other Departments Bldg/TI/Addn/Rem Size 1.01 0 — ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone , r-3 Number of Stories /J+ Overlay/Agreement G V - Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use I v IW -*WI(Li Occupancy Group iz-a, Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ['Update Existing ❑New System ZINot Req'd planning/Landscape Inspection Required before Final? ElYesNlfro Reason Sprinklers Required: _ "In Lie :Type: �,- Amount$ Fire Alarm: ❑Update Existing El New System dNot Req'd School Impact Fee: Reason Fire Alarm Required: Calculated: it: RCW 64.55 MF worksheet req'd for permit? ['Yes 21 No erett School Dist ❑Mukilteo Schoo Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: pia .P --fci(`I`(/( al re J 1nw VALUATION CALCULATION: Total$ ooiiif ed afpr,J of w 0 -(-h;s p.6r i it . Approved By: Date: IQ I /� PUBLIC WORKS r I Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: L6S�d$ Date: (3*f, ❑Backflow Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, isupportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ['Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 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 located in this folder l3 Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) O Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By: 4 Date: ��IV Public Works has no scope---PW Not Required Additional Notes: _ ELECTRICAL * (/wI k4f 4/-rik � , i-c Additional Notes: re" -r �i,,y1,5--g l.�•t Approved By: Date: Approved By: Li" Date: y/ /1,0 2.-/z__