1607 RUCKER AVE 2023-04-07 - Laserfiche WebLink

• S Intake & Approval Sheet (FOR PERMIT STAFF ONL19 PERMIT#`J 2_.1 t 0 — 0 `c)\ BUILDING PLANNING Intake OK by: Date: Intake OK byalS Assign To:n 11 i e. Date: / '' 0AA 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 'U a Zone -Z Number of Stories Z Overlay/Agreement �x a-6(a/ ( ffiS CGGitflad" Basement , No ❑Yes, Fin/Unfin Nonresidential Use ((�� Type of Construction .!' Residential Use (5.F1 -- Occupancy Group L4C_ Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System SNot 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 ill 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'l RCW 64.55 docs required prior to final? ❑Yes inNo Additional Notes: VALUATION CALCULATION: Total$ ,<O Jbo.btu / Approved By: g/f.) Date: i61/2V/2.6Lit PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: .P ......................................................,,.,.,,,,.,.,.,,.,,,,...,,...............,,,.,...,........................,,, Worksheet Needed if: ❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By �_ Date:�� I(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 OCreate 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 ❑ 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: Z/