3805 RUCKER AVE 2023-04-07 - Laserfiche WebLink

Intake &Approval Sheet 4111 (FOR PERMIT STAFF ONLY) • PERMIT# ®t ® ( 7 BUILDING . . . PLANNING" • . - -- Intake OK by: Date: Intake OK byraa Assign To: Date:p/ 1 /ZZ _ 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 0 Hold in Planning File Drawer Garage/Accessory Struct.Size Zone al l 0 Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use . 1 r-c rr 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: ❑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 ❑ No DEverett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes El No Additional Notes: VALUATION CALCULATION: Total$ 7 coo,OD . T"if►tt(\k tr-� 4 VjV 117 Approved By: Date: PUBLIC WORKS'' Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: 'OSys Dev Eval OTraffic Mit Eval OSite Work or Drainage Proposed Approved B •' ,,AL,"" Date:4i/D0-0'if... OBackflow Prevention for high hazard: _(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT El 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 ODeferred 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(loin 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: 14,Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: =j/20/24 s2 Approved By: Date: Approved By: Date: