3416 ROCKEFELLER AVE 2023-06-30 - Laserfiche WebLink

Intake & Approval Sheet _ (FOR PERMIT STAFF ONLY) - PERMIT # �j2Z� �'� BUILDING pp`` Intake OK by: f—i to Date: t� 3 22 Intake Comments: ❑ Route to Commercial Building 01 Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn em Size `SZ Garage/Accessory Struct. Size Number of Stories -2— Basement ❑No JRYes Fin Unfin Type of Construction S� Occupancy GroupC Occupancy Load FireSprinklers: ❑Update Existing ❑New System Mot Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System o&Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes EYNo Add'I RCW 64.55 docs required prior to final? ❑Yes No VALUATION CALCULATION: Total $ Additional Notes: Approved By: (Le -j Date: fp 3 ZZ FIRE DEPARTMENT Separate / Deferred Submittals Requ' d: ❑Fire Sprinklers ❑Fire Alar Other: Additional Notes: Fire Dept. Fees• ❑ Review As -Built Plans - NO FIRE FEE ❑ Min' al or No Fire Scope - NO FIRE FEE ❑ eview / Inspection Scope - ADD FIRE FEE Approved By: Date: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: CANNING Intake OK by: Assign To: Date: Intake Comments: Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes ❑No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukilteo School Dist Park Impact Fees for permits applied for after 1/1/2022: Park Impact Fee Total $ Fee Schedule Used For Calculation (Year): Permit Technicians: Apply Credit Per EMC19.53.200 ❑ 100% Credit- Issued 1/1/2022 - 9/2/2022 ❑ 50% Credit - Issued 9/3/2022 - 6/2/2023 ❑ 0% Credit - Issued 6/3/2023 or later Additional Notes: Approved By: Date: PUBLIC WORKS Intake OK by:2 Date: --------- --- --- ---- ----------------- Intake Comments: PW Worksheet Needed if.• ❑Sys Dev Eva[ ❑Traffic Mit Eva] ❑Site Work or Drainage Proposed ❑Backflow 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 Additi al Notes: ait Iln-wi a� 0 05 v Approved By: Date: 2�_