1630 RUCKER AVE 2023-05-23 - Laserfiche WebLink

Intake &Approval Sheet •(FOR PERMIT STAFF ONLY) • PERMIT# g it 0 S- 00Z BUILDING PLANNING Intake OK by: . Date: (Pi 1 11-.3‘ Intake OK by: Assign To: Date: Intake Comment Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. 0 Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit ❑ OK to Route to Other Departments Bldg/ /Addr em Size Z'/y dg ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size YE; Zone x. Z Number of Stories 2— Overlay/Agreement ri- Basement ❑No Ryes, Fin/Unfin Nonresidential Use _ Typ-,e of Construction /2C Residential Use 5 -- Occupancy Group .Z/Ze__ Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: CI Update Existing ❑New System QNot Req'd Planning/Landscape Inspection Required before Final? ❑YesNo Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: CI Update Existing ❑New System lallot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: . r Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes I:.� No El Everett School Dist ❑Mukilteo School Dist Add.'RCW 64.55 docs required prior to final? ❑Yes -No Additional Notes: VALUATION CALCULATION: Total$4' Oa de O0 Kore". 0.49a0e on L. 1. U 6 Iluric. Approved By: I., ,A j Date: el.R. LJ UBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date( 7/Q 7/wZi ❑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) 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(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: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: — Date: ---//, 7.04