3927 RUCKER AVE BASE FILE 2020-01-30

Intake &Approval Sheet (FOR PERMIT STAFF ONLY PERMIT# N of _of " BUILDING PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building ❑Attach to Project No. _ ❑ Route to Residential Building 0 Route to Historic Reviewer O Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zc ne fj-1- M 00 Number of Stories Overlay/Agreement (-%J 0 Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes IXo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing El New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No DEverett School Dist ❑Mukilteo Schoo ist 1 Add'!RCW 64.55 docs required prior to final? ❑ IYes ❑No Additional Notes: o1G -- �s'fiO' L A\ _ VALUATION CALCULATION: Total$ `5(y1� �' ,.� '( 9 � � � ° i � "10/•-146610..$ . Approved By: 14, Date: ) 14— 161 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Need • if: ❑Sys Dev Eval •Traffic Mit Eval ❑Site Work • Drainage Proposed Approved By: `g1l1 Date: II 41 lid ❑Backflo Prevention for high hazard: / (dental, ' edical,animals,mortuary,hospital, I supp. ive housing) FIRE DEPARTMENT DRoute this folder for PW Review a -nd ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separa • concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder •Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approve.by Public Works Date: (OK to Route to Other Departments) 0 See PW Review W. ksheet and associated attached items Fire Sprinklers: ❑Update Existing :New System 0 Not Req'd 0 A Separate PW rermit is Required (Permit#: PW Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is loc. -d in this folder Chemical Sup: ❑Update Existing ONew System 0 Not Req'd 0 Is i a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Publi• Works has no scope---PW Not Required Additi. al Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: