2421 ROCKEFELLER AVE 2022-03-23 - Laserfiche WebLink

Intake & Approval Sheet &FOR PERMIT STAFF ONLY) 0 PERMIT # 12- ®0 S BUILDING Intake OK by: Date: Intake Comments: It ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement []No ❑Yes , Fin / Unfin Type of Construction Occupancy Group L✓�� Occupancy Load Fire Sprinklers: []Update Existing []New System 1PNot Req'd Reason Sprinklers Required: Fire Alarm: ❑ Update Existing ❑ New System PNot Req'd 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 VALUATION CALCULATION: Total Additional Notes: Approved B ` Date: / ll FIRE DEPARTMENT Separate / Deferred Submittals Required: []Fire Sprinklers ❑Fire Alarm []Other: Additional Notes: !� Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE ❑ Review/ Inspection Scope -ADD FIRE FEE Approved By: Date: ELECTRICAL Additional Notes: Approved By: Date: PLANNING' Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Z. Overlay/Agreement Nonresidential Use . Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes QNo "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Additional Notes: Approved By: Date: II PUBLIC WORKS: Intake OK by: Date: ......... _... ............. .,_..,..,,......... ..... ......... ............... -......... ..;.,................ ......... .,,.w. Intake Comments: [PW Worksheet Needed if., 11Sys Dev Eval ❑Traffic'Mit Eval []Site Work or Drainage Proposed 1111Backflow Prevention for high hazard: '(dental, medical, animals, mortuary, hospital, €supportive housing) ❑Route this folder for PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder []Submitted Previously [Deferred ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit ##: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date: