1208 RUCKER AVE 2022-02-15 - Laserfiche WebLink

• • Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#C2<03 O?2 , 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 ❑ Route to Historic Reviewer ❑ Make this a"W" Permit ❑ OK to Route to Other Departments Bldg/TI/Addn/Rem Size z(cS-"7g/-" ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone 1); \l&C Number of Stories Overlay/Agreement Di— '. 7..--Basement ❑No EYes, Fin Un Nonresidential Use �,n Type of Construction Ll�v� Residential Use Q ' ` � c ' t/� Occupancy Group � = Proposed No.of Dwelling Units: v Occupancy Load ie � ��° Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System /Not Req'd Planning/Landscape Inspection Required before Final? Yes Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System UNot 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 DMukilteo School Di Add'I RCW 64.55 docs required prior to final? ❑Yes ��mNo Additional Notes: /�/ 'v S, l vi-Z�3 VALUATION CALCULATION: Total$ .�7; G<<N `^cor DA 01 Approved By: \1 l Date: '�,4V 4 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval l" Or-diI_ e*/`!' ? ?2-,,A /t ❑Site Work or Drainage Proposed Approved By: /j/ //Date: J % ❑Backflow Prevention for high hazard: / :(dental,medical,animals,mortuary,hospital, !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 ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ 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 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: