1707 RUCKER AVE 2022-05-10 - Laserfiche WebLink

III) Intake & Approval Sheet (FOR PERMIT STAFF ONLY • PERMIT# 132.0 l 2,-0 ( __ 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 ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size y7 i .e..t _ Zone Number of Stories ( Overlay/Agreement Basement _MNo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction i/I Residential Use Occupancy Group S-1- 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: ❑Update Existing ❑New System SNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 13 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes .1No Additional Notes: VALUATION CALCULATION: Total$ 27/ 700 e" 143X 4g '— 27 72? / Approved By: Date: PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval I DSite Work or Drainage Proposed i s❑Backflow Prevention for high hazard: Approved By: r-L ,z Date: ��G �'�' d :(dental,medical,animals,mortuary,hospital, isupportive 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: 0 This Permit is Approved by Public Works El,‘See PW Review Worksheet and associated attached items Fire Dept. Fees: Ej A Separate PW Permit is Required (Permit#: PW 29 k2. 0 t{Z ) ❑ Review of As-Built Plans-NO FIRE FEE AND Er 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: ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: f.\ Date: •�' ? 1 z1