3226 RUCKER AVE REAL PROPERTY FUNDING GRP 2021-12-22

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# PW 3"00Z BUILDING PLANNING Intake OK by: ati— Date: 5�/0% Intake OK by: I-'TT Assign To:V-. Date: Intake Comments: Intake Comments: -3-.j&-Zdzo 1104 v4202- e.i.cLA C4 442- t3C,V ZO-c ❑ Route to Commercial Building ,Attach to Project No. Iv CU W —001 lq Route to Residential Building ❑ Route to Historic Reviewer Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size IZS" £4 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone ,, UK-- Number of Stories rr 2- Overlay/Agreement rp m ❑ Is Basement No Yes 0/Unfin Nonresidential Use Type of Construction It ' Residential Use o, Occupancy Group K. Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: `- Fire Sprinklers: El 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 ❑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 MtNo ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 51No Additional Notes: VALUATION CALCULATION: Total$ ?O,000 A reQa 0-6 "O 4 Approved By: ( p Date: 3-K,?Z,p PUBLIC WORKS Intake OK by: Date: d Intake Comments: PW Worksheet Needed if: Additional Notes: 'To is /jtG ��.rG PVC e /tAyt,7T S s Dev Evan'"` Traffic Mit Eval _ Site Work or Drainage Proposed Approved By: Date: ? lI❑Backflow Prevention for high hazard: pp ✓isj° zo fp.kErei:idi-t !(dental,medical,animals,mortuary,hospital, 5 f ;supportive housing) FIRE DEPARTMENT pgRoute this folder for Re w at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: his Permit is Approved by Public Works rdSee PW Review Worksheet and associated attached items Fire Dept. Fees: II-A Separate PW Permit is Required (Permit#: PW w Zoo3.002) ❑ Review of As-Built Plans-NO FIRE FEE ANDs 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 ❑ Will be issued separately(Separate Green Folder,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: b 341 /Zd`z (gb