3000 ROCKEFELLER AVE ADMIN BLDG WEST 2024-10-25

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# B�3 0,7? — OW BUILDING • •LANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone ry Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use CYO\fr ui I d iv( ❑ Route to Residential Building Residential Use El Make this a"W"Permit Proposed No.of Dwelling Units: Bldg/TI/Addn/Rem Size /w 4,3 N Total No.of Dwelling Units: Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu"Fee:Type: Amount$ Basement ❑No ❑Yes, Fin I Unfin School Impact Fee: Total $ ' Type of Construction A Calculated: Credit: Occupancy Group se „1/ ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load 29'/ ic iv Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers4Lifeal ❑New System =\of Req'd Park Impact Fee Total$ -' (net due after credit for existing uses) Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ,bJpdate Existing ❑New System ❑Not Req'd Permit Technician Use Only:Apply Phase-In Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes a No 0 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ONo 0 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total$02-7 via 40 Additional Notes: / . --91rYVL/( 1r/0 q 3 / 7 /2, Approved By: Date: PUBLIC WORKS Additional Notes: /JO 5 Pot Intake OK by: Date: �y f /f� .% i°1-5 Intake Comments: PW Worksheet Needed if.- /aw ` /.(i ❑Sys Dev Eval(Utit/sw)CDTraffic Mit Eval Approved B� Date: 6 ❑Site Work/Drainage ❑Address Letter VI-043- ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate I Deferred Submittals Required: DRoute this folder for PW Review at end --PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑This Permit is Approved by Public Works Fire Dept.Fees: ❑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 El Is located in this folder Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Gob with this folder for permit issuance) Approved By: tbmcii Date: _)y 23 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: 41/1-61050,_ Approved By: Date: Completed By: Date: