3000 ROCKEFELLER AVE COURTHOUSE 2025-04-18

- ROSi ON nn Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT # 8�, _V 4 BUILDING Intake OK by: Date: Intake Comments: ❑ Make this a "W" Permit ❑ SRC Required (Pre-Insp) Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Cert. of Occpuancy Required? []No ❑Yes ❑Shell Only Code Year 1:12021 02018 112015 Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Reason Sprinklers Required: Fire Alarm: ❑{Jpdate Existing ❑New System []Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? []Yes ❑ No Add] RCW 64.55 docs required prior to final? ❑Yes ❑No VALUATION CALCULATION: Total $ A- '�32-�,1i I p,,t� Additional Notes: Approved By: Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: El 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/PLUMBING Additional Notes: Approved By: Date: PLANNING 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 $ (net due after credit for existing uses) Fee Schedule Used For Calculation (Year): Additional Notes: Approved By: Date: PUBLIC WORKS Intake OK by: Date: _.....,,_.,. ............................ _.......... _........ .................................................. ......_........................ . Intake Comments: iPINReview& Worksheet Needed if. ❑Sys Dev Eval ❑Water ❑Sewer ❑Storm i ❑Traffic Mitigation Eval ❑Site Work/Drainage (shown/triggered) []Address Letter ❑Backflow Prevention for high hazard: '(dental, medical, animals, mortuary, :hospital, supportive housing) ❑ 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 fully digital ❑ Is located in this folder ❑ Is in a Separate Green Folder (join with this folderfor permit issuance) ❑ Will be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope on this permit --- PW Not Required Additional Notes: Completed By: Date: