2525 RUCKER AVE 2023-06-22 - Laserfiche WebLink

Intake &Approval Sheet !FOR PERMIT STAFF ONLY) • PERMIT#1\9t o C° O 33 BUILDING PLANNING Intake OK by: Date: Intake OK by: Zi Date: Intake Comments: Intake Comments: Assign To: ❑ 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/Tl/Addn/Rem Size Q. O 4 ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size Zone Number of Stories I Overlay/Agreement Basement EiNo ❑Yes , Fin/Unfin Nonresidential Use Type of Construction V 0 Residential Use Occupancy Group •l3 / ,3 Proposed No. of Dwelling U 's: Occupancy Load /lr/A Total No. of Dwelling Uni :: Fire Sprinklers: ❑Update Existing ❑New System N1Not Req'd Planning/Landscape spection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type; Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact F-e: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑Everett •chool Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Addition- Notes' f� / / �n'� VALUATION CALCULATION: Total$ �g d!o d ?G� niil�` CG«'f'"`� Approved By: JJ2$ Date: 6. i",//i 1 PUBLIC WORKS Intake OK by: li Date: Additional Notes: Intake Comments: PW Worksheet Needed if: //�� yj/f�(�/s' ❑Sys Dev Eval ❑Traffic 1 it Eval hs� ` " ,lj�Cf ❑Site Work or Drainage •roposed 1 ❑Backflow Preventio• for high hazard: Approved By: j Date: Jir.G� 1 f i (dental,medical,ani s,mortuary,hospital, supportive housin. FIRE DEPARTMENT El Route this folder for PW Review at end --- Review Worksheet Separate I Deferred u mittals Required: ❑This project also has a separate conc ent PW Review(Green Folder) ❑Fire Sprinklers ire Alarm ❑Other: AND ❑Create Green Folder ❑Su. itted Previously ❑Deferred Additional Notes: ❑This Permit is Approved by P.•lic Works ❑ See PW Review Works -et and associated attached items Fire Dept.Fees: 0 A Separate PW Pe • it is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIRE FEE AND 0 Is locat=. in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is i. a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 , ill be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ P •lic Works has no scope---PW Not Required Ad.' ional Notes: ELECTRICAL Additional Notes: / Approved By: y�/j4 Date: Approved By: LI Date: 6 f p?l/6 i