423 ROCKEFELLER AVE 2023-05-31 - Laserfiche WebLink

Intake & Approval Sheet 0 (FOR PERMIT STAFF ONLY) S PERMIT# C200TI BUILDING PLANNING Intake OK by: Date: Intake OK by:( J Assign To: ,\\,ex 6 Date: '•Zq.Ze: Intake Comments: Intake Comments: - ‘e,, Q\OA csy\secs A22&.& ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"PermitK to Route to Other Departments Bldg/TI/Addn/Rem Size 4 4.{-1- (Q 0 Hold in Planning File Drawer Garage/Accessory Struct.Size (D !4-'' Zone r. I Number of Stories 2- Overlay/Agreement Basement UINo ❑Yes, Fin/Unfin Nonresidential Use Type of Construction V- j Residential Use 6 Fi2- Occupancy Group R,'j Proposed No.of Dwelling Units: 1 Occupancy Load Total No.of DwellingUnits: I p Y Fire Sprinklers: ❑Update Existing ❑New System ®Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Jo Reason Sprinklers Required: "In Lieu"Fee:Type: - ntJ Fire Alarm: ❑Update Existing ❑New System ®Not Req'd School Impact Fee: Total $ SU sI 3S5 Reason Fire Alarm Required: ��hh Calculated: / Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes Igi No Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes J No Additional Notes: VALUATION CALCULATION: Total$ 0 1 ( -i- o4.0) 62 t) = 4t 4,0 60 41 1!;) - U Ste$ Approved By:A Date: S./5--Z6',..--J ISv (2,d5 = 461.- 0.0 15.s. 4.3(k� 3 0 `t moo PUBLIC.WORKS fanti 0A I VI`1'' )01►' e) Intake OK by: Date'...._._...._...........-......_................_... ._...................._.. Additional Notes: 3I Ii X \z1. (6(9)(4C`' Intake Comments: PW Worksheet Needed if: 1 x 30.E V ❑Sys Dev Eval ❑Traffic Mit Eval 60 30' aV° ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By: Date: 4 8 ,Zp�„l (dental,medical,animals,mortuary,hospital, l supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet w~ 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 0/See PW Review Worksheet and associated attached items Fire Dept.Fees: qA Separate PW Permit is Required(Permit#: PW 0-0G4-- 0 3 ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ilEr Minimal or No Fire Scope-NO FIRE FEE 2 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: y.„,VN6-0(A/n Date:9-4-,202,0 ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: z/L- 1