2110 ROCKEFELLER AVE 2022-03-02 - Laserfiche WebLink

Intake &Approval Sheet 4110 (FOR PERMIT STAFF ONLY) PERMIT# - 2-0 666 . BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: ' %:4' '.-%4 Intake Comments: Intake Comments: ❑ Route to Commercial Building %Attach to Project No. I 1 (J,g 2-0 00 ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit A/OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Y 75 S/' Zone . Number of Stories ] Overlay/Agreement Basement IKINo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction ve Residential Use S Occupancy Group V( Proposed No.of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required befo e Final? Ekes L,IFAIo Reason Sprinklers Required: "In i Fee:Type:_ Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact F e to Reason Fire Alarm Required: Calculated: edit: RCW 64.55 MF worksheet req'd for permit? ❑Yes CR No ❑Ever chool Dist ❑Mukilteo Schoo ist, Add!RCW 64.55 docs required prior to final? ❑Yes 24No A ditional Notes: VALUATION CALCULATION: Total$ I !!6 i Approved By:`*, Date: 4/ I 'Z$2-1 PUBLIC WORKS Intake OK by: Date: Additional Notes: 2 Q It. t Z , Intake Comments: :PW Worksheet Needed if: DSys Dev Eval ❑Traffic Mit Eval =DSite Work or Drainage Proposed Approved By: Date: / //Z ® _DBackflow 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ELThis 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 ) 0 Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder IELMinimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) beiikMVitsgqinspecuurr51-1411------ADD FIRE FEE ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By:frb,37.3 f.,J I Date: - ❑ Public Works has no scope---PW Not Required - Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved Date: ,fir 6e. to /obi