1612 ROCKEFELLER AVE 2025-04-17 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# -21 &o1Z BUILDING "PLANNING Intake OK by: (1.Q4-1 Date: 16 JS/ZZ Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement O Route to Commercial Building Nonresidential Use Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No. of Dwelling Units: Bldg/TI/Addn/Rem Size 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/Unfin School Impact Fee: Total $ Type of Construction -i-�—� Calculated: Credit: Occupancy Group 742.4 ❑Everett School Dist ❑Mukilteo School Dist Occupancy Load - Park Impact Fees for permits applied for after 1/ 022: Fire Sprinklers: ❑Update Existing ❑New System Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System 0-Not Req'd Permit Technicians:Apply Credit Per EMC1•. 3.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2' 2 RCW 64.55 MF worksheet req'd for permit? ❑Yes No 0 50%Credit-Issued 9/3/2022-6/2 023 Add'I RCW 64.55 docs required prior to final? ❑��Yessr, ErNo 0 0%Credit-Issued 6/3/2023 or -ter VALUATION CALCULATION: Total $ 9��pw Additional Notes: Approved By: fy, z I Date: ..-""= a •UBL IC WORKS Additional Notes: Intake OK by: Date: 10!OM 12497) v — t S f'L=�?�01�S ��QC ll�� Intake Comment PW Worksheet Needed if: OSys Dev Eval ❑Traffic Mit Eval Approved By: (Lp Date: (0/5 Z2 DSite Work or Drainage Proposed ❑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 ❑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 0 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 ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ty Public Works has no scope---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: t� 1 b I'I 12Avz Approved By: Date: Approved By: Date: