5102 RUCKER AVE 2021-09-08 - Laserfiche WebLink

Intake &Approval Sheet 0 (FOR PERMIT STAFF ONLY) Ill PERMIT# L2-1 Q I 'D 2L BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑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 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 . 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 ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: r•3 . ,ora . VALUATION CALCULATION: Total$ ��G J V or1- j YV11 + V' VVvilAsl J UV„ 0 t� tm-1 t1� Y ra\t,c Approved By: �. 4 Date: 1. Z ', Z, VJ \ o�1 nto1 Ali► m�/6t 'c ' „ . : PUBLIC WORKS --g14/0 tk ID '6&( 'IIcK Ovi - Intake OK by: Date: Additional ote �� Orovu /V WV'' \1/ Intake Comments: PW Worksheet Needed if. . �� Wit) � ❑Sys Dev Eval Traffic Mit Eva! Inrn�/NH�i�IJ OSite Work or Drainage Proposed \ Approved By: Date: itiA !❑Backflow Prevention for high hazard: ^� (dental,medical,animals,mortuary,hospital, ` )^ d l ;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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 1 ❑This Permit is Approved by Public Works .. " ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ 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 Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: