1511 RUCKER AVE 2019-11-07 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# (69,(9 - a BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments ildg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone I'- -2-Number of Stories Overlay/Agreement KVC}=6r-G t'Gcvtof t ( -tjird Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use — I�"� Type of Construction 7-13 Residential Use .512 d Occupancy Group (,,( Proposed No. of Dwelling Units: — Occupancy Load Total No. of Dwelling Units: i Fire Sprinklers: ❑Update Existing :blew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Reason Sprinklers Required: "In Lieu"Fee. •e: Amount$ Fire Alarm: ❑Update Existing ❑New System ONot Req'd School Impact Fee: • = Reason Fire Alarm Required: Calculated: it: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Ever- 'chool Dist ❑Mukilteo Schoo Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total$ 500 11"pprove-f -For re& 'to oI e aa.o;rnri t-h'wS_. i f FYI a pio►'6 J Torr-HiS11r i C Over Ia. (els. Approved By: (j�/� Date:1 y II 1 !�" PUBLIC WORKS Intake OK by: Tti\ Date: ?I:7 / 1 9 Additional Notes: Z O i S /QC Intake Comments: PW Worksheet Needed if: e..or l C. ?A7 S ‘,4A"e..,, , OSys Dev Eval DTraffic Mit Eval L'�1R.ce �,T ❑Site Work or Drainage Proposed Approved By: <l-ft Date: CIAo` ., i_ - OJ ❑Backflow Prevention for high hazard: / (dental,medical,animals,mortuary,hospital, iC 5 S;,4 a_, 2ao s F supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 1,5 This Permit is Approved by Public Works 0 See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 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: Date: 0 Public Works has no scope---PW Not Required Additional Note-: - / - ELECTRICAL Additional Notes: _ Approved By: Date: Approved By: Date: