3805 RUCKER AVE 2023-04-07 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# JZZ(D"0 5) 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" "Permit ❑ OK to Route to Other Departments Bldg/TI/Ad�i/ em e ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size ,A/O Zone Number of Stories I Overlay/Agreement Basement ,®No ❑Yes, Fin/Unfin Nonresidential Use 14 i Type of Construction Vg Residential Use Occupancy Group A Z. Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing El New System pNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes PrNo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing El New System ElNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: � Calculated: Credit: ❑ 1 RCW 64.55 MF worksheet req'd for permit? Yes Z1 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 15INo Additional Notes: VALUATION CALCULATION: Total $ 3, OG-4,00 Approved By: ILI Date: 6,, 1? 7i7-e___, CPUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: I PW Worksheet Needed if: ?❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Date: ��/��bZZ ❑Backflow Prevention for high hazard: Approved B j� (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) El 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 12 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: \<, roc.tiin Date: 7_i9.Ze2 ❑ Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By: Date: