2720 ROCKEFELLER AVE 2022-01-31 - Laserfiche WebLink

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) 4111 PERMIT# Z01 t"©M BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To:_ Date: _ Intake Comments: Intake Comments: • ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: CI Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 does required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ _ V,rgI,_ Atc!-(----- do GatO paL 1f715 4.4O v ra Approved By: I l Date: 1 /W Fc rum L,/»2R D' PUBLIC WORKS Intake OK by: Date: `Additional Notes: ' Intake Comments: 1 PW Worksheet Needed if: tj` v ; I lA j 1,, l��s T. —Q� ' IOsys Dev Eval ❑Traffic Mit Eval DSite Work or Drainage Proposed Approved By Date,:(Q/t/ � '�Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, !supportive 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: t l 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 ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ®.Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: ).( ,WY1 Date:q/291,&270 0 Public Works has no scope---PW Not Required Additional Notes: 15v -e-�µt-r taVacr�a FO¢. ELECTRICAL 5i+7c..:.r4' -' - Additional Notes: -Ng. v-na.� epN(;,-t,00 Approved By: Date: Approved B . Date: 0 9/2,5126 r-o „, 4 i