1015 ROCKEFELLER AVE 2024-04-11 - Laserfiche WebLink

ZZ Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# f�'p�30(- BUILDING � g • •ANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone e -2 Overlay/Agreement 0 Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use �j c)�le;s ❑ Make this a"W" Permit Proposed No. of Dwelling Units: "Y Bldg dd /R-fm Si 311 ( 5 p Total No.of Dwelling Units: Garage/Accessory Struct. Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories 2- "In Lieu"Fee:Type: Amount$ Basement glNo ❑Yes, Fin/Unfin School Impact Fee: Total $ a5 Type of Construction .L10,4- Calculated: Credit: Occupancy Group "IVE- ❑Everett School Dist ❑Mukilteo School Dist Occupancy Loader Park Impact Fees for permsapplied for after 1/1/2022: Fire Sprinklers: ❑Update Existing ONew System e;Not•Req'd Park Impact Fee Total$ (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calc ation(Year): Fire Alarm: ❑Update Existing ❑New System EiNot Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: 1-c9 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF Worksheet req'd for permit? ❑Yes No 0 50%Credit-Issued 9/3/2022-6/2/2023 Addl RCW 64.55 docs required prior to final? ❑Yes 3No 00%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$ L{-1000 Additional Notes: gIn(1 14‘di)- eZ/IV-3 Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: de Date: b l` 2$12O2" Intake Comments: PW Worksheet Needed it ❑Sys Dev Eval(Util/SW)OTraffic Mit Eval Approved By: Ike H Date: lilt f'l2o 2- OSite Work/Drainage )]Address Letter lj /r ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end --PW Review Worksheet El Fire Sprinklers ❑Fire Alarm El Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred 0 This Permit is Approved by Public Works Fire Dept.Fees: 0 See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE ❑A Separate PW Permit is Required(Permit#: PW ) ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING dditional Notes: Additional Notes: ill JAQATIvA� ' 61, I 23 I 2,52�j Approved By: Date: Completed : Date: