2930 RUCKER AVE SECOND LOOK CONSIGNMENT 2021-08-30

• Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 1O a(/ BUILDING PLANNING Intake OK by: Date: Intake OK by: g Date: 'i /s Intake Comments: Intake Comments: Assign To:-7 ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement — Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use COII/K 2fa( 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 o Reason Sprinklers Required: "In LI " Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Total $ Reason Fire Alarm Required: Calculated: Cr : RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist i chool Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ SS 210 OO Approved By: a" ' ) Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ['Sys Dev Eval ['Traffic Mit Eval ❑Site Work or Drainage Proposed Approved Bx Date: G9//3/.0/9' ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT ❑Route this folder for P 'eview at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a sep:rate concurrent PW Review(Green Folder) `- r.ir Sprinklers El Fire Alarm ❑Other: AND ❑Create Green Folder I< ubmitted Previously ❑Deferred Additional es: ❑This Permit is Approved by Public.Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑A Separate PW Permit is Required (Per°fit#: PW ❑ Review of As-Built Plans 0 FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-N c IRE FEE ❑ Is in a Separate Green Folder(join with thi older for permit issuance) ❑ Review/Inspection Scope-ADD 'E FEE ❑ Will be issued separately(Separate Green Folde PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: