2525 RUCKER AVE 2023-06-22 - Laserfiche WebLink

\in Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT# 2b03--t& BUILDING PLANNING Intake OK by: . % Date:. 11'12O2-`� Intake OK by: Y-1 Assign To: a Date: j'—lb—ZDZ.L Intake Comme f.: Intake Comments: W N 5 5 V a• ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit p OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone 0 Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El 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: El Update Existing El New System El 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'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: c V\RT1'9-61 VALUATION CALCULATION: Total$ Approved By: 1 Date: �j _if—a.0 ZZ PUBLIC WORKS Intake OK by:,}2 i( Date: 0 VIA Additional Notes: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval ❑Site Work or Drainage Proposed Approved By: Date:"/+fie/Qa►,1'0 €❑Backflow Prevention for high hazard: i(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 El Fire Alarm ❑Other: AND El Create Green Folder ❑Submitted Previously El Deferred -rf . Additional Notes: This Permit is Approved by Public Works Y—.4Rew e, 1(�OO-1,—601 El See PW Review Worksheet and associated attached items Fire Dept.Fees: 0 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) VI-Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: ... (Ow Date: —7—O2,O "Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: )40.9-9s-- Date: 6 e-i f yj